Medicare Fraud Overshadows Medicaid Investigations

Letter writer argues Dr. Oz should focus more on Medicare fraud than Medicaid issues

Published on Feb. 24, 2026

Got story updates? Submit your updates here. ›

A letter writer argues that Dr. Oz, as administrator of the Centers for Medicare and Medicaid Services, should concentrate more on investigating Medicare fraud rather than Medicaid issues. The writer cites examples of Medicare Advantage providers, such as Martin's Point Health Care, having to repay millions in inflated payments to Medicare, which the writer says is a much larger issue than the Medicaid fraud allegations Dr. Oz has pursued in Maine.

Why it matters

This letter highlights concerns about the scale and prevalence of Medicare fraud, which may be a more significant issue than the Medicaid fraud investigations Dr. Oz has focused on as head of CMS. The writer argues that well-respected healthcare providers have engaged in questionable billing practices that have cost taxpayers millions, raising questions about oversight and enforcement in the Medicare system.

The details

The letter cites a 2023 report that Martin's Point Health Care, the writer's Medicare Advantage provider, had to refund $22 million in inflated payments to Medicare after an internal review found unsupported illness codes had been used. The letter also references a 2022 New York Times article estimating $12 billion in overpayments to Medicare Advantage programs in 2020, as well as a $1.1 million overpayment discovered by Gateway Community Services in a Medicaid audit.

  • On August 1, 2023, the Portland Press Herald reported that Martin's Point Health Care would refund $22 million in inflated payments to Medicare.
  • In October 2022, the New York Times reported an estimated $12 billion in overpayments to Medicare Advantage programs in 2020.

The players

Martin's Point Health Care

The writer's Medicare Advantage provider that had to refund $22 million in inflated payments to Medicare after an internal review found unsupported illness codes had been used.

Gateway Community Services

An organization that discovered $1.1 million in Medicaid overpayments in an audit for 2021 and 2022.

Dr. Oz

The administrator of the U.S. Centers for Medicare and Medicaid Services who the letter writer argues should focus more on investigating Medicare fraud than Medicaid issues.

Got photos? Submit your photos here. ›

The takeaway

This letter highlights the need for greater oversight and enforcement of Medicare billing practices, which may be a more significant issue than the Medicaid fraud investigations Dr. Oz has pursued as head of CMS. The examples provided suggest that well-respected healthcare providers have engaged in questionable billing that has cost taxpayers millions, raising concerns about the scale and prevalence of Medicare fraud.