2026年6月10日 美国东部时间下午2:07 / 福克斯新闻
据美国政府问责局（GAO）消息，该项目覆盖超过820万名联邦雇员及其家属
作者：阿什利·J·迪梅拉 福克斯新闻
宾夕法尼亚州总检察长详解该州1200万美元医疗补助欺诈破获案
宾夕法尼亚州总检察长戴夫·周日详细说明了费城一家药房的1200万美元医疗补助欺诈破获案，该药房涉嫌为从未配给过的处方虚假申领数百万美元医疗补助报销款。
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【福克斯独家报道】 福克斯新闻数字频道获悉，特朗普政府正针对覆盖数百万美国人的联邦健康福利计划展开整治，要求保险公司加强欺诈防控，作为打击浪费和滥用行为全面行动的一部分。
美国人事管理局（OPM）局长斯科特·库珀对福克斯新闻数字频道表示：“我们与白宫消除欺诈特别工作组并肩合作，正采取额外措施保障联邦雇员缴纳的保费和纳税人的资金，保护受益人权益，并确保健康保险公司达到最高问责标准。”
美国人事管理局是联邦政府的人力资源机构，负责文职人事政策管理，并为联邦雇员、退休人员及其家属提供福利。
福克斯新闻数字频道获悉，美国人事管理局将与白宫消除欺诈特别工作组合作，于周三向联邦雇员健康福利计划和邮政服务健康福利计划的保险公司发出新的合规要求，指示它们加强欺诈预防、付款审查、药房福利监督、分包商问责、审计和报告工作。
阅读原文： 奥兹医生就数十亿美元医疗补助欺诈问题警告全美50州
2024年，联邦雇员健康福利计划（FEHB）耗资约700亿美元，覆盖超过820万名联邦雇员、家属及其他符合条件的人员。（杰弗里·格林伯格/环球图片集团通过盖蒂图片社供图）
此次整治行动还将矛头指向药房福利管理商——即为健康计划管理处方药福利、与制药商和药房谈判的药品定价中间商。
据美国政府问责局数据，2024财年，联邦雇员健康福利计划耗资约700亿美元，覆盖超过820万名联邦雇员、家属及其他符合条件的人员。
白宫消除欺诈特别工作组执行主任斯科特·布雷迪对福克斯新闻数字频道表示：“美国人事管理局是该工作组的宝贵合作伙伴和领导者。今日采取的举措将保护纳税人利益和我们的联邦 workforce。”
美国人事管理局还将与该局监察长合作组建一支数据科学和审计团队，审查匿名索赔数据，更主动地发现欺诈、浪费和超额计费行为。
众议院共和党人成立新特别工作组，调查俄亥俄州据称2500亿美元医疗补助欺诈案
白宫特别工作组已加大欺诈调查力度，聚焦医疗腐败问题。（奥利弗·孔特雷拉斯/法新社通过盖蒂图片社供图）
美国政府问责局在2025年7月的一份报告中指出，美国人事管理局应采取更多措施管理联邦雇员健康福利计划中的欺诈风险，列举的风险包括福利卡转借、不当利诱、文件不全或欺诈、回扣、营销欺诈、个人身份信息被盗、提供商资质不合格以及自我转诊等。
此次公告是在全国范围内启动医疗补助调查后，医疗项目领域最新的打击欺诈行动。
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美国人事管理局已要求负责联邦雇员健康福利的保险公司对付款、药房福利监督和分包商展开调查。（埃里克·塞耶/彭博新闻通过盖蒂图片社供图）
今年4月，美国医疗保险和医疗补助服务中心（CMS）指示全美50个州提交计划，重新审核高风险医疗补助提供商，包括那些注册标准不够严格或未获得国家提供商标识符的提供商。
领导该工作组的副总统JD·万斯在5月强化了这一呼吁，他在一场新闻发布会上表示，如果各州不积极打击医疗补助欺诈，可能会失去联邦资金。
此次行动正值社会对大规模欺诈案件关注度提升之际，其中包括明尼苏达州价值2.5亿美元的“喂养我们的未来”骗局，该事件近期成为全国关注的焦点。
阿什利·J·迪梅拉为福克斯新闻数字频道报道政治新闻。
https://www.foxnews.com/video/6397754942112
First on Fox: Trump admin opens new front in fraud crackdown targeting health insurers, drug middlemen
June 10, 2026 2:07pm EDT / Fox News
The program covers more than 8.2 million federal employees and family members, according to the GAO
By Ashley J. DiMella Fox News
Pennsylvania Attorney General details his state’s $12 million Medicaid fraud bust
Pennsylvania Attorney General Dave Sunday explains a $12 million Medicaid bust of a Philadelphia pharmacy that allegedly fraudulently collected millions in Medicaid reimbursements for prescriptions it never fulfilled.
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FIRST ON FOX:The Trump administration is lifting the hood on federal health benefits programs that cover millions of Americans, ordering insurance carriers to tighten fraud controls as part of a broader crackdown on waste and abuse, Fox News Digital learned.
“Working alongside the White House Task Force to Eliminate Fraud, OPM is taking additional steps to safeguard the premiums paid by federal employees and taxpayers, protect beneficiaries, and ensure health insurance companies are meeting the highest standards of accountability,” said Office of Personnel Management (OPM) director Scott Kupor to Fox News Digital.
OPM functions as the federal government’s human resources agency, overseeing civilian personnel policy and administering benefits for federal employees, retirees and their families.
OPM, partnered with the White House Task Force to Eliminate Fraud, is sending new compliance expectations on Wednesday to insurance carriers in the Federal Employees Health Benefits and Postal Service Health Benefits programs, directing them to strengthen fraud prevention, payment reviews, pharmacy benefit oversight, subcontractor accountability, audits and reporting, Fox News Digital learned.
READ: DR. OZ PUTS ALL 50 GOVERNORS ON NOTICE OVER BILLIONS LOST TO MEDICAID FRAUD
FEHB cost taxpayers about $70 billion and covered more than 8.2 million federal employees, family members, and other eligible individuals in 2024.(Jeffrey Greenberg/Universal Images Group via Getty Images)
The push also targets pharmacy benefit managers, the drug-pricing middlemen that administer prescription drug benefits for health plans and negotiate with drugmakers and pharmacies.
The FEHB program cost the government and enrollees about $70 billion in fiscal 2024 and covered more than 8.2 million federal employees, family members and other eligible individuals, according to the U.S. Government Accountability Office.
“OPM is a valuable partner and leader on the Task Force. The steps taken today will protect taxpayers and our federal workforce,” White House Task Force Executive Director Scott Brady told Fox News Digital.
OPM is also building a data science and audit team with the agency’s inspector general to review anonymized claims data and detect fraud, waste and overbilling more proactively.
HOUSE GOP LAUNCHES NEW TASK FORCE, PROBES ALLEGED $250B MEDICAID FRAUD IN OHIO
The White House Task Force has amped up its fraud investigations, narrowing in on medical corruption.(Oliver Contreras / AFP via Getty Images)
The Government Accountability Office said in a July 2025 report that OPM should do more to manage fraud risks in the FEHB program, citing risks including benefit card sharing, improper inducements, insufficient or fraudulent documentation, kickbacks, marketing fraud, theft of personally identifiable information, provider ineligibility and self-referrals.
The announcement marks the latest crackdown in medical programs following the launch of a nationwide probe into Medicaid.
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OPM has given orders to insurance companies handling federal employee health benefits to launch investigations into payments, pharmacy benefit oversights, and subcontractors.(Eric Thayer/Bloomberg via Getty Images)
CMS directed all 50 states to submit plans to revalidate high-risk Medicaid providers, including providers subject to less rigorous enrollment standards or operating without a National Provider Identifier in April.
Vice President JD Vance, who is leading the task force, amplified the call in May, saying during a news conference that states could lose federal funding if they fail to aggressively pursue Medicaid fraud.
The push comes amid heightened focus on large-scale fraud cases, including Minnesota’s $250 million “Feeding Our Future” scheme, which became a national flashpoint in recent months.
Ashley J. DiMella reports on politics for Fox News Digital.
https://www.foxnews.com/video/6397754942112
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