Dr. Mehmet Oz, Administrator of the U.S. Centers for Medicare and Medicaid Services (CMS), recently urged California Governor Gavin Newsom to provide detailed information regarding program integrity, eligibility verification, and provider oversight to address the “major fraud” in the state’s in-home supportive services spending. In his video, Dr. Oz claims that everyday personal care tasks such as bathing, cleaning, and cooking are Medicaid fraud and divert funds from other programs nationwide. His framing goes beyond California, creating a dangerous and misleading narrative that questions the legitimacy of home and community-based services across the country.

In the video, he pushes this narrative further by arguing that California’s spending on in-home care takes money away from federal taxpayers and programs that other states rely on, even claiming that the state’s “expansion” of services means fewer Americans elsewhere can access vital supports. He suggests that basic personal care tasks are things family members should simply “take over,” and that government-funded assistance ends up with unethical people. This framing ignores the basic human rights of Disabled people and reduces essential care to optional household favors, rather than the skilled, safety-critical support it is.

The claims misrepresent what In-home and home health care are

In-home care and home health care are two different but equally essential supports that allow disabled people and older adults to live safely in their own homes.

In-home care, often called personal care in New York, provides non-medical assistance with activities of daily living (ADLs) and other household tasks referred to as instrumental activities of daily living (IADLs). ADLs include bathing, grooming, dressing, mobility support, and transportation. IADLs include tasks such as meal preparation, cleaning, and grocery shopping. These services ensure the safety, dignity, and independence of individuals, helping them avoid unnecessary dangers and institutionalization.

Home health care is medical or clinical support. This can include nursing care, wound care, physical therapy, occupational therapy, medication management, and monitoring chronic conditions. Home health care helps people recover from more acute illness or injury, manage long-term health needs, and remain stable in their communities.
Both types of care require training, oversight, and consistency. This isn’t “favors” from family. In some self-directed programs like New York’s CDPAP, families can provide these services. But that decision is up to the Disabled individual. For instance, a 22 year old woman may not be comfortable with her father showering or toileting her.

Further, many disabled people don’t have family who can provide the daily support either because they moved to pursue life options, their parents are deceased or physically unable, or they have work and cannot give that up. Finally, it is important to note that, in our society, when we say “family”, what is often left unstated is that we mean “daughters and mothers.” The Government should not be involved in furthering harmful stereotypes that too often prevent access to college and the workplace or stall advancement in a career for women.

Why this message is harmful; threatens beyond California

The message Dr. Oz spreads, calling California’s in-home and home health care “fraud,” is dangerous and undermines the legitimacy of home and community-based services. Claiming that it takes away from other programs nationwide is false information that lacks data and is based on privilege, ableism, and stereotypes. It is a playbook that disabled communities are all too used to.

It is incorrect to suggest that California’s in-home care programs divert funds from other states, or even other programs in California. These in-home services are usually part of federally approved state plans for Medicaid and are considered a critical component of the Medicaid system overall.

California, just like all states, has also taken measures to address and prevent the misuse of these funds. Newsom’s administration revoked over 280 licenses from hospice operators over the last two years. False claims of fraud not backed up by evidence or data threaten not only California’s In- Home and Home Health care programs but also similar services across other states. It perpetuates harmful stereotypes about Disabled people and the dedicated workers who provide them with services. This narrative shapes the public’s opinion and allows for even deeper cuts in the future – as we have seen time and time again in the past. It is not only a matter of funding, but also the narrative that will be used to question restricted home and community-based services everywhere. This directly threatens ADA and Olmstead protections that guarantee Disabled people the right to live in the community.

Real issues: Workforce & underfunding, not fraud

When taken out of context, many of the claims of even actual fraud can be astronomical in size. When you hear “four million dollars in fraud”, your first thought is “Oh my God!!” When you dive deeper and realize that four million dollars is potentially two-thirds of one percent of $600 million in total funding, it is different. While these numbers are hypothetical, this is the situation we see play out time and time again. Of course, we should all strive for zero fraud, but we do have to look at it in context.

The real issues that Dr. Oz should be focusing on are the underlying issues: workforce shortages, low wages, rising demands due to a rapidly increasing population of older adults and Disabled people needing more support. When these pressures pile up, of course, you’ll find bad actors taking advantage. That’s true in any system, particularly one that represents billions of dollars across the country, but instead of touring Los Angeles and posing for TV cameras while labeling entire sectors as “fraud” or “mafia,” Dr. Oz should be conducting a serious investigation into structural problems we already know exist. The public deserves a government that offers solutions, not distractions and wild accusations.

Home and Community-based services are not fraud. They are fundamental human and civil rights. Disabled people and older adults deserve the supports that allow them to live safely, with dignity, in their own homes