Medicaid Fraud War Room flags $203 million; nearly 10,000 UC physicians move to unionize; Fauci takes the Fifth — Morning Medical Update Weekly Recap

Medicaid Fraud War Room flags $203 million in first 88 days

CMS' first report on the data-driven unit flags 50 high-risk Medicaid providers, but exclusion notices are not criminal charges, and no money has been recovered.

CMS announced July 28 that its Medicaid Fraud War Room identified 50 unique high-risk Medicaid providers tied to approximately $203.3 million in payments made since Jan. 1, 2025, during the unit's first 88 days of operation. Launched April 23 in coordination with the White House Anti-Fraud Task Force, the operation brings together CMS, the HHS Office of Inspector General, state Medicaid agencies and federal law enforcement, using data analytics to flag suspicious billing patterns before payments go out rather than recovering money after the fact.

The OIG issued 42 federal notices of intent to exclude Medicaid providers from federal health care programs, representing roughly $160.7 million in payments, and states took 15 enforcement actions based on War Room referrals, representing about $46.2 million. Seven were subject to both federal and state action. CMS did not name the flagged Medicaid providers, notices of intent are not completed exclusions and none of the totals represent recovered funds or criminal charges. "If you steal from Medicaid, we will track you down, cut you off," CMS Administrator Mehmet Oz, M.D., said in the release.

The July 28 release is the unit's first official accounting. The administration first described the War Room publicly at a July 21 news conference announcing more than $1 billion in Medicaid payment deferrals to California and Minnesota, where Jetson Leder-Luis, deputy executive director and chief economist of the White House Anti-Fraud Task Force, said the unit uses machine learning to flag suspicious claims before they are paid and reviews dozens of new Medicaid fraud cases each week.

Nearly 10,000 UC attending physicians launch union drive

Organizers call it the largest unionization effort of attending physicians in U.S. history; the University of California says it respects employees' right to organize.

Nearly 10,000 attending physicians across the University of California system are moving to unionize with SEIU Doctors United, in what organizers describe as the largest unionization effort of attending physicians in U.S. history. The campaign, UC Doctors United, launched July 23 outside Zuckerberg San Francisco General Hospital and held a second launch event July 28 outside Ronald Reagan UCLA Medical Center. SEIU Doctors United is a partnership of the Doctors Council, SEIU, and the Committee of Interns and Residents that together represents more than 45,000 physicians nationwide.

The physicians say they are organizing for a voice in patient care, safety, staffing, workloads, medical education and research decisions, describing unsustainable patient loads and shrinking clinical autonomy in what they call an increasingly corporatized system. The drive follows a tentative agreement covering UC resident and fellow physicians that includes an 18% salary increase, which organizers cite as proof of what bargaining can deliver. The University of California said it deeply values its physicians, takes concerns about workload, staffing and workplace safety seriously and respects employees' rights under applicable law to organize.

Fauci takes the Fifth; Senate committee schedules contempt vote

The former director of the National Institute of Allergy and Infectious Diseases declined to answer questions about the origins of COVID-19; the committee votes on contempt next week.

Anthony Fauci, M.D., former director of the National Institute of Allergy and Infectious Diseases, invoked the Fifth Amendment July 29 and declined to answer questions before the Senate Homeland Security and Governmental Affairs Committee, where he appeared under subpoena as part of Chairman Rand Paul's investigation into the origins of COVID-19. Days earlier, Paul released more than 1,000 pages of Fauci's personal journal entries from December 2019 to December 2022, and much of the hearing's questioning drew on them.

Paul argued the Fifth Amendment does not apply because former President Joe Biden preemptively pardoned Fauci before leaving office, while acknowledging that may be a question for the courts to decide. Fauci said answering could expose him to new legal jeopardy, accused Paul of an "unhinged" obsession with him and noted he has answered questions from Congress repeatedly in past hearings. Democrats on the committee generally defended him, and one of Fauci's attorneys, David Schertler, was removed from the hearing room by U.S. Capitol Police at Paul's direction after repeatedly attempting to speak without being recognized.

Paul said the committee, where Republicans hold an 8-7 majority, will vote next week on a contempt resolution. Any contempt action would also require approval by the full Senate.

Senate panel advances CDC nominee Erica Schwartz

A full Senate vote is unlikely before the August recess.

The Senate Health, Education, Labor and Pensions Committee voted 13-10 on July 30 to advance Erica Schwartz, M.D., J.D., M.P.H., President Donald Trump's third nominee to lead the Centers for Disease Control and Prevention, to the full Senate, with Sen. Tim Kaine (D-Virginia), the only Democrat voting in favor. If confirmed, Schwartz would be the agency's first permanent director since Susan Monarez was fired last year after less than a month in the role. A final vote may not come until September.

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