WASHINGTON, DC – Today, Rep. David Schweikert, Chairman of the Joint Economic Committee and Chairman of the House Ways and Means Oversight Subcommittee, announced he has filed legislation to combat home health fraud. The Combating Deceptive Practices in Assistance Programs Act would tighten requirements for an individual to be eligible for home health services in Medicaid.

Additionally, the Joint Economic Committee released an issue brief entitled From Care to Cash: Correcting Misaligned Incentives in Home Health outlining how some states, particularly New York, have outsized spending on home health care well beyond what would be expected given their senior population. In New York, health care and social assistance are by far the largest job growers with home health aides per residents over 65 being well over twice as high as the national average. Also, under Medicaid in New York they spend nearly $1,000 more per resident than the next highest state. The Joint Economic Committee estimates that if New York’s per resident Medicaid spending was the same as the national average, they would have spent nearly $43 billion less in 2024. Today, Chairman Schweikert asked Health and Human Services Secretary Kennedy about this issue during the Secretary’s appearance before the House Ways and Means Committee.

In order to provide better oversight to an industry with few guardrails, and in turn reduce fraud in the Medicaid program, Chairman Schweikert’s bill would require recipients to prove they are unable to perform three or more Activities of Daily Living (ADLs), activities which include bathing, personal hygiene and grooming, eating, dressing and general mobility. This requirement adds additional federal oversight to home health services while also tightening eligibility to ensure that only individuals who need assistance are receiving funding.

“If we seriously want to preserve Medicaid, and provide for the people most in need, we must crack down on fraud,” said Rep. Schweikert. “Reaching people that need these services the most should be the top priority of these programs, not growing one of the largest jobs corps in the state. With the U.S. adding almost $87,000 per second to our national debt, making commonsense reforms can save tens of billions of dollars while protecting the truly vulnerable.”

Through a variety of broad federal waiver programs, state Medicaid systems are allowed to provide long-term, at home care to individuals to help prevent them from entering a nursing home. While all 50 states have at least some forms of at home care model, federal guidelines are broad enough that these waivers give states wide authority to oversee their models, which can lead to a lack of guardrails intended to prevent waste, fraud, and abuse. A lack of adequate federal oversight has led to specific states having especially egregious policies. In fact, DOJ and various state Attorney’s General/State’s Attorney offices have made several indictments regarding fraudulent home healthcare claims.

New York’s state Medicaid program is particularly susceptible to fraud due to its Consumer Directed Personal Assistance Program (CDPAP) which allows individuals eligible for home health care through Medicaid to choose their caregiver, which can include friends or family members, many with little to no experience or training. Today, more than 250,000 people are enrolled into the program with around 400,000 total caregivers.

With both limited standards to meet for an individual to be eligible for services, and little to no training required for caregivers, this has led to an explosion in spending in NY State’s Medicaid program. In fact, in 2019, NY spent approximately $2.5 billion, in 2023 that number reached $9.1 billion. More recent analysis estimates that spending in 2025 is around $12 billion with continued spending growth despite attempts by the governor to reform what she has called “one of the most abused programs in the history of New York.”

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