CMS Reviews California’s Medi-Cal Program Amidst Fraud Concerns

New York, NY, August 7, 2026 —

The U.S. Centers for Medicare & Medicaid Services (CMS) has initiated a review of California’s Medi-Cal program, citing concerns over potential fraud, waste, and corruption. The agency characterized the review process as akin to diagnosing an illness, suggesting a thorough examination to identify and address systemic issues within the state’s Medicaid program.

Medi-Cal, California’s Medicaid program, provides health coverage to millions of low-income residents. Reviews by CMS are a standard oversight mechanism aimed at ensuring the integrity and efficiency of programs funded by federal and state dollars. The specific details regarding the scope and duration of this particular review were not immediately available.

The focus on fraud, waste, and corruption indicates that CMS is investigating potential improper payments, beneficiary eligibility issues, or provider misconduct. Such reviews can involve audits, data analysis, and site visits to assess compliance with federal regulations and program guidelines.

While the analogy of diagnosing an illness suggests a detailed and potentially complex investigation, CMS has not provided further specifics on the suspected nature or extent of the problems within the Medi-Cal program. The outcome of the review could lead to recommendations for corrective actions, policy changes, or enhanced oversight measures to safeguard program funds and ensure beneficiaries receive appropriate care.

The contractor’s name involved in the review process was not provided. The total financial impact of any potential fraud, waste, or corruption, as well as any potential fines or recoveries, has not yet been determined or disclosed.

Story summarized from the original created by Dr. Mehmet Oz, Dan Brillman on nypost.com, see more information here.