CMS says home care fraud is rampant. What do the data show?

O. Rose Broderick reports on the health policies and technologies that govern people with disabilities’ lives. Before coming to STAT, she worked at WNYC’s Radiolab and Scientific American, and her story debunking a bogus theory about transgender kids was nominated for a 2024 GLAAD Media Award. You can reach Rose on Signal at rosebroderick.11.

In February, the U.S. DOGE Service released a gigantic dataset showing Medicaid provider spending from every month from 2018 to 2024. Social media buzzed with eye-popping numbers and claims of widespread fraud as the government insurer’s home care spending more than doubled from $937 million per month to $2.15 billion per month over that period. 

That alarmed Victor Hunt, CEO of Zingage, a business that wants to keep “grandma out of the hospital.” Hunt’s business uses artificial intelligence to help home-care providers manage things like scheduling and care coordination. He dug into the newly released Medicaid data — and found a much murkier picture.

“Things that look like fraud are happening, but it’s not this mass orchestration of fraud at a company level, but rather individual actors within the system who are sort of ripping off the agency,” Hunt told STAT. For Hunt, and his business, claims of widespread fraud in home-based care that older Americans and those with disabilities depend on is an existential threat.