2026-05-13 12:02:32 UTC / 路透社
作者:乔迪·戈多伊 与 考特尼·罗森
2026年5月13日 12:02 PM UTC 更新于27分钟前
2026年5月5日,美国副总统JD·万斯在爱荷华州得梅因市的制造工厂Ex-Guard Industries出席与众议员扎克·纳恩(R-IA)共同参与的活动。路透社/吉姆·冯德拉斯卡 摄
此次举措是万斯医疗诈骗专项工作组的行动之一
此次暂停将为政府留出时间审查相关账户
打击欺诈行动始于明尼苏达州
(5月13日 路透电)根据周三发布的一份政府声明,特朗普政府将在至少未来六个月内,阻止新型家庭医疗及临终关怀机构加入医疗保险计划,理由是担忧普遍存在的欺诈行为。
这项临时禁令将暂时禁止上述类别中的新机构申请医疗保险报销。医疗保险是面向65岁以上美国民众及残疾人群体的联邦政府健康保险项目。负责监管该项目的医疗保险和医疗补助服务中心(CMS)表示,该禁令不会影响已在医保系统注册的机构。
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这是副总统JD·万斯领导的反欺诈专项工作组打击医疗诈骗的最新举措。
多年来,美国政府一直致力于打击医疗保险流向临终关怀及家庭医疗服务机构的欺诈性支付。
诈骗分子可向医保机构申领患者无需或未曾接受的临终关怀或家庭医疗服务账单,从而从美国政府手中骗取数百万美元。全国欺诈预防组织“老年医保监督团”已多次就该问题发布警报。
医保和医疗补助服务中心过往曾在特定县怀疑存在欺诈时暂停新机构注册,例如2013年,该机构禁止佛罗里达州迈阿密-戴德县的新机构加入医保。
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“此举旨在保护患者、恢复诚信并守护纳税人的钱,”医保和医疗补助服务中心负责人穆罕默德·奥兹在一份声明中说道。
路透社率先报道了此次暂停注册的消息。一名政府官员表示,此次临时禁令将为医保和医疗补助服务中心留出时间,梳理医保项目下临终关怀与家庭医疗的支出情况,并制定额外指导细则。
特朗普政府此前因将总统政治偏好与机构消除政府支付欺诈的工作混为一谈而受到批评。该政府点名包括加利福尼亚州和明尼苏达州在内的一些民主党领导州,称其在打击欺诈方面力度不足。但该政府去年也加强了对佐治亚州和俄亥俄州临终关怀机构的监管,这两个州均由共和党领导。
行业内的不同立场
根据医保支付咨询委员会的数据,2024年共有180万医保受益人接受临终关怀服务,相关支出达283亿美元。同年,270万医保患者接受了家庭医疗服务,支出达160亿美元。该委员会负责就医疗支出向国会提供建议。
万斯的专项工作组近期已针对临终关怀服务采取行动,尤其是在加利福尼亚州。该州审计员2022年曾指出,监管松懈导致大规模欺诈行为滋生。
在特朗普政府权衡可能采取的行动时,行业团体呼吁采取不同的应对方式。
全国医疗与临终关怀创新伙伴关系组织3月表示,支持暂停临终关怀机构的注册。全国家庭护理联盟则警告称,采取过于宽泛的行动可能会阻碍医生和患者推荐或寻求相关医疗服务。
美国主要的家庭医疗运营商包括BrightSpring Health Services(BTSG.O)、私募股权背景的Matrix Medical Network以及联合健康集团(UNH.N)。Chemed Corporation(CHE.N)旗下子公司VITAS Healthcare是顶级临终关怀服务提供商之一。
更广泛的打击行动
根据全国医疗保健反欺诈协会的数据,美国每年因医疗欺诈损失的金额估计达数百亿美元,这意味着患者和雇主需要承担更高的成本。
美国总统特朗普政府还试图打击其认定存在欺诈风险的其他医疗保健领域。今年2月,该政府暂停了假肢等耐用医疗设备供应商的医保注册资格。
打击欺诈的行动始于明尼苏达州。特朗普政府今年2月宣布,将扣留2.59亿美元的医疗补助资金。医疗补助是由联邦和州政府共同运营的面向低收入美国人的医保项目。
特朗普多次提及明尼苏达州2020年的一起丑闻,当时有47人被控从州运营、联邦资助的儿童营养项目中骗取2.5亿美元。据当地新闻报道,该案的许多被告是索马里裔美国人。
这场争议促使特朗普今年早些时候派遣数千名联邦移民官员开展移民打击行动。在联邦官员开枪打死两名抗议其政策的民众后,他调整了策略,采取了不那么激进的方式。
今年3月宣布成立欺诈专项工作组时,特朗普在未提供证据的情况下表示,民主党领导州的欺诈指控率高于共和党领导州。
乔迪·戈多伊在纽约报道,罗萨尔巴·奥布莱恩与比尔·伯克罗特编辑
本报守则:路透社信托原则
Exclusive: US freezes Medicare enrollments for new home healthcare and hospice providers
2026-05-13 12:02:32 UTC / Reuters
By Jody Godoy and Courtney Rozen
May 13, 2026 12:02 PM UTC Updated 27 mins ago
U.S. Vice President JD Vance speaks during an event with Representative Zach Nunn (R-IA), at Ex-Guard Industries, a manufacturing facility in Des Moines, Iowa, May 5, 2026. REUTERS/Jim Vondruska
Move is part of Vance task force on healthcare scams
Pause will give government time to scrutinize accounts
Fraud crackdown began in Minnesota
May 13 (Reuters) – The Trump administration will block new home healthcare and hospice providers from enrolling in Medicare for at least the next six months, according to a government statement posted on Wednesday, citing concerns about widespread fraud.
The moratorium will temporarily bar new providers in those categories from signing up for reimbursement from Medicare, a U.S. government health insurance program for Americans aged 65 and older and those with disabilities. It will not impact providers already registered with Medicare, according to the Centers for Medicare & Medicaid Services, which oversees the program.
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It is the latest move by Vice President JD Vance’s anti-fraud task force that aims to crack down on healthcare scams.
The U.S. government has for years tried to tackle fraudulent payments from Medicare to hospice and home healthcare providers.
Scammers can bill Medicare for hospice or home healthcare services that the patient doesn’t need or want, allowing them to rake in millions of dollars from the U.S. government. The national fraud prevention group Senior Medicare Patrol has repeatedly issued alerts on the issue.
CMS has paused enrollments in the past in specific counties when staff suspected fraud, including in 2013, when it barred new providers based in Florida’s Miami-Dade County.
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“This is about protecting patients, restoring integrity and safeguarding taxpayer dollars,” said CMS Administrator Mehmet Oz in a statement.
Reuters was first to report on the pause. The moratorium will give CMS time to account for hospice and home health expenditures under the Medicare program and create additional guidance, an administration official said.
The Trump administration has been criticized for mixing the president’s political preferences with agency efforts to eliminate fraud in government payments. The administration singled out some Democratic-led states, including California and Minnesota, as not doing enough to combat fraud. But it also ramped up oversight of hospices in Georgia and Ohio last year, both led by Republicans.
DIFFERENT APPROACHES FROM INDUSTRY
In 2024, 1.8 million Medicare beneficiaries received hospice care at a cost of $28.3 billion, according to the Medicare Payment Advisory Commission. The same year, 2.7 million patients on Medicare received home healthcare at a cost of $16 billion, according to the agency which advises Congress on healthcare spending.
Vance’s task force has recently taken action against hospice services, particularly in California, where the state auditor said in 2022 that lax oversight had enabled large-scale fraud.
Industry groups had urged different approaches as the Trump administration weighed potential action.
The National Partnership for Healthcare and Hospice Innovation said in March it supported temporarily pausing hospice provider enrollments. The National Alliance for Care at Home warned against overly broad action that could deter doctors and patients from recommending or seeking care.
Major home health operators in the U.S. include BrightSpring Health Services (BTSG.O), private equity-backed Matrix Medical Network, and UnitedHealth Group (UNH.N). Chemed Corporation (CHE.N) subsidiary VITAS Healthcare is among the top hospice care providers.
BROADER CRACKDOWN
Tens of billions of dollars are estimated to be lost in the United States through healthcare fraud each year, translating into higher costs for patients and employers, according to the National Health Care Anti-Fraud Association.
The administration of U.S. President Donald Trump has also sought to tackle other healthcare sectors it has deemed a fraud risk. The administration in February paused Medicare enrollments by suppliers of durable medical equipment, such as prostheses.
The fraud crackdown started in Minnesota, where the Trump administration said in February it would withhold $259 million in funds for Medicaid, the federal- and state-run program for lower-income Americans.
Trump has repeatedly invoked a scandal in Minnesota that dates back to 2020, in which 47 people were accused of defrauding $250 million from a state-run, federally funded child nutrition program. Many of the defendants in that case were Somali Americans, according to local news reports.
The controversy prompted Trump earlier this year to send in thousands of federal immigration officers as part of a migrant crackdown. He shifted tactics to a less aggressive approach after federal officers shot dead two people protesting his policies.
In announcing the fraud task force in March, Trump, without providing evidence, said fraud allegations were higher in Democratic-led states than in Republican-led states.
Reporting by Jody Godoy in New York, Editing by Rosalba O’Brien and Bill Berkrot
Our Standards: The Thomson Reuters Trust Principles.
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