联邦再暂缓加州12亿美元医疗补助款：CMS 称个人护理服务三年增长24%
华盛顿——美国医疗保险和医疗补助服务中心（Centers for Medicare & Medicaid Services, CMS）主任 Mehmet Oz 10月20日在白宫椭圆形办公室的一场活动上宣布，卫生与公众服务部（Department of Health and Human Services, HHS）将再暂缓向加州支付12亿美元联邦医疗补助（Medicaid）款项，涉及该州的个人护理服务项目。Oz 表示，他是代表卫生与公众服务部长 Robert F. Kennedy Jr. 作出这一宣布，加州官员当天已经收到通知。
Oz 给出的理由是增速：加州 Medicaid 个人护理服务的核准规模过去三年增长24%，是全美各州平均增速的两倍。他说：「我们实在无法理解怎么会这样。」他还表示，这类服务中有些是为老年人和残障人士提供的日常协助，例如替母亲把杂货拎上楼，「很多人会免费为母亲做这件事」。据《洛杉矶时报》报道，Oz 在宣布时没有出示欺诈证据。
这不是联邦政府第一次暂缓加州的医疗补助款。今年5月，联邦政府曾以临终关怀与居家护理项目涉欺诈为由，暂缓13亿美元报销款。加州州长办公室当时称那次行动是出于政治动机的攻击，并指出居家支持服务（In-Home Supportive Services, IHSS）让老年人和残障人士留在家中、避免入住养老院：该项目人均年成本约3万美元，而养老院护理约为13.7万美元。加州方面此前还表示，联邦政府没有提供充分的欺诈证据，项目增长源于需求上升。截至各家媒体发稿时，加州州长办公室尚未就这笔新的暂缓作出回应。
Oz 是在白宫当天宣布「欺诈举报奖励计划」（WHIP）的活动上宣布这一决定的；该计划动用2,500万美元，鼓励公众举报联邦项目欺诈。联邦政府今年以来已多次以反欺诈为由收紧对加州医疗补助资金的拨付，加州与联邦政府围绕这笔资金的争议仍在持续。
关联：特朗普与万斯宣布2500万美元举报奖励计划：线索促成定罪最高奖3万美元
（GSM 据白宫官方活动及彭博法律、《洛杉矶时报》、《华盛顿观察家报》报道）
HHS to Defer Another $1.2 Billion in California Medicaid Payments, CMS Administrator Announces at White House
WASHINGTON — Mehmet Oz, Administrator of the Centers for Medicare & Medicaid Services (CMS), announced at a White House Oval Office event on October 20 that the Department of Health and Human Services (HHS) will defer another $1.2 billion in federal Medicaid payments to California, directed at the state's personal care services. Oz said he was making the announcement on behalf of Secretary of Health and Human Services Robert F. Kennedy Jr., and that California officials had been notified the same day.
Oz cited the program's growth: California's approvals for Medicaid-covered personal care services have grown by 24% in the last three years, twice the average rate of every other state. "Impossible for us to understand how that could be so," he said. He noted that such services include everyday help for older adults and people with disabilities, such as carrying groceries upstairs for one's mother, something "many of you would carry groceries upstairs for your mom for free." According to the Los Angeles Times, Oz did not provide evidence of fraud in making the announcement.
It is not the first such deferral. In May, the federal government withheld $1.3 billion in reimbursements over suspected fraud in hospice and in-home care programs. California Governor Gavin Newsom's office at the time called that move a politically motivated attack and argued that In-Home Supportive Services (IHSS) keeps seniors and people with disabilities out of nursing homes, costing about $30,000 a year per person compared with about $137,000 for nursing home care. California officials have also said the federal government has not provided sufficient evidence of fraud and that the program's growth reflects rising demand. The Governor's office had not responded to the latest deferral in the initial reports.
Oz made the announcement during the White House event unveiling the Fraud Whistleblower Incentive Program (WHIP), a $25 million program rewarding tips that lead to fraud convictions or major enforcement actions. The federal government has repeatedly tightened Medicaid funding to California this year on anti-fraud grounds, and the dispute between the state and Washington over the funds is continuing.
Related: Trump and Vance Announce $25 Million Fraud Whistleblower Incentive Program
(GSM, based on the official White House event and reporting by Bloomberg Law, the Los Angeles Times and the Washington Examiner)
来源：GSM·美国（原文链接）
图片来源：图：位于华盛顿的美国卫生与公众服务部（HHS）总部大楼入口（资料图）。Photo: G. Edward Johnson, CC BY 4.0, via Wikimedia Commons / Entrance to the headquarters of the U.S. Department of Health and Human Services in Washington (file photo). Photo: G. Edward Johnson, CC BY 4.0, via Wikimedia Commons.
GSM Global · 本篇英文版 English edition of this story
