The Centers for Medicare & Medicaid Services (CMS) announced today increased federal oversight to stop states from misusing federal Medicaid dollars to cover health care for individuals who are in the country illegally. Under federal law, federal Medicaid funding is generally only available for emergency medical services for noncitizens with unsatisfactory immigration status who would otherwise be Medicaid-eligible, but some states have pushed the boundaries, putting taxpayers on the hook for benefits that are not allowed.
“Medicaid is not, and cannot be, a backdoor pathway to subsidize open borders,” said CMS Administrator Dr. Mehmet Oz. “States have a duty to uphold the law and protect taxpayer funds. We are putting them on notice—CMS will not allow federal dollars to be diverted to cover those who are not lawfully eligible.”
As part of the action, CMS is ramping up financial oversight across the board to identify and stop improper spending. This includes:
- Focused evaluations of select state Medicaid spending reports (CMS-64 form submissions);
- In-depth reviews of select states’ financial management systems; and
- Assessing existing eligibility rules and policies to close loopholes and strengthen enforcement.
“Medicaid funds must serve American citizens in need and those legally entitled to benefits,” said CMS Deputy Administrator and Director of the Center for Medicaid & CHIP Services Drew Snyder. “If states cannot or will not comply, CMS will step in.”
CMS is also urging all states to immediately examine and update internal controls, eligibility systems, and cost allocation policies to ensure full compliance with federal law. Any improper spending on noncitizens will be subject to recoupment of the federal share.
This effort aligns with President Trump’s broader focus to restore integrity to federal programs, secure the border, and put Americans first. CMS will continue to act decisively to ensure Medicaid dollars serve their true purpose—protecting people eligible for the program under federal law.
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