The FBI’s New York Field Office announced this week that it has joined an interagency working group targeting Medicaid fraud in the state, with one sector at the top of the list: social adult day care.
Here’s the number that got their attention. Between 2019 and the closing stretch of the Biden administration, New York Medicaid paid out roughly $2.4 billion for social adult day care — programs meant to support elderly residents in community settings. Across the board, Medicaid spends 40 to 60 percent more per New York enrollee than the national average.
New Yorkers are not 40 percent sicker than other Americans. They don’t have 40 percent more elderly residents. There is no clinical explanation for that gap, which leaves the other kind.
CMS administrator Dr. Mehmet Oz has been making unannounced visits to these facilities, and Fox News captured one of them. Oz confronts a New York City senior day care director with billing records showing more seniors receiving services than were physically in the building. “Ma’am, this is fraud,” he tells her. She disputes it. He keeps asking.
"Ma’am, this is fraud."
Dr. Oz confronts a New York City senior day care director during a surprise visit, questioning Medicaid billing records that appear to show more seniors receiving services than are actually present.
Dr. Oz presses the director over the discrepancies as federal investigators expand their crackdown on suspected fraud at senior care facilities across the city. The director disputes the concerns, but Oz isn’t finished asking questions.
See what else investigators uncover during the surprise inspections: https://t.co/XXBgS4qi5W
@foxnewspolitics
— Fox News (@FoxNews) October 20, 2026
That is the entire scheme in one exchange: bill Medicaid for seniors who aren’t there. It requires no sophistication, only the confidence that nobody will walk through the door and count heads. For roughly six years, nobody did.
James Barnacle Jr., who runs the FBI’s New York office, described the referral in blunt terms — significant indicators of waste, fraud, and abuse in the social adult daycare sector, and a working group built to disrupt billion-dollar health care fraud schemes along with the money-laundering networks that move the proceeds.
Money laundering. That phrase tells you the Bureau isn’t chasing sloppy paperwork. It’s chasing organized operations.
And New York has been content to let it run. This is the state governed by Kathy Hochul, whose administration refused to verify suspected ineligible voters on request and whose approach to oversight has been consistently to look elsewhere. It’s the state where Letitia James built a career on investigating a single real estate developer while a multibillion-dollar fraud matured in her own backyard, unexamined. New York City now has a mayor whose principal governing interest is obstructing federal immigration enforcement.
A state where auditing fraud is nobody’s job will have a great deal of fraud. It is also the same pattern Minnesota produced with Feeding Our Future — hundreds of millions stolen through a program with no site verification, while officials who could have checked chose not to, mostly thanks to the large Somali community in Minneapolis, who also gave us Ilhan Omar.
The administration has added an incentive that Albany never bothered with: a whistleblower program paying one percent of substantial recovered fraud. On $2.4 billion, that math gets interesting fast, and somebody in one of those billing offices is running it right now.
Barnacle’s message was simple enough. Report it to tips.fbi.gov. Six years of unexamined invoices are about to get examined.
