Former House Speaker Newt Gingrich and former Louisiana Governor Bobby Jindal have issued a joint warning that fraud in Medicare and Medicaid programs is threatening the ability of seniors to receive care at home, a goal they say is central to President Donald Trump's healthcare agenda. In an opinion piece published this week, the two Republican leaders argue that while advances in artificial intelligence, telehealth, remote monitoring, and home health services are making it possible for more older Americans to age in place, the integrity of these programs is being undermined by widespread abuse.
Gingrich and Jindal note that most older Americans prefer to remain in their homes, maintaining independence and connection to family and community. They describe aging in place as a matter of dignity and quality of life, not merely a personal preference. President Trump, they point out, recognized this reality when he pledged to help seniors stay in their homes longer. Since returning to office, his administration has taken steps such as signing legislation to extend Medicare's Acute Hospital Care at Home program through 2030, continuing implementation of the GUIDE dementia model, and preserving telehealth flexibilities that allow care to be delivered directly to patients.
However, the authors caution that the success of home-based care depends on public confidence that these programs are operating as intended. They highlight troubling examples of fraud, including an investigation in Los Angeles County that identified more than 100 hospice providers operating from a single office building. They also describe sophisticated home health fraud networks that repeatedly cycled the same Medicare beneficiaries among multiple agencies to generate new rounds of federal payments while evading traditional detection systems.
Gingrich and Jindal also express concern about a recent announcement that more than 1 million people signed up for Obamacare benefits without valid Social Security numbers, calling it alarming even though it is not specific to eldercare. They argue that every major expansion of healthcare benefits depends on public trust. If taxpayers conclude that these programs are vulnerable to widespread waste and abuse, support for continued expansion will weaken, honest providers will face greater scrutiny, and seniors who rely on these services may ultimately pay the price.
The authors praise President Trump's efforts to combat fraud, including launching major healthcare fraud investigations, establishing a government-wide anti-fraud task force chaired by Vice President J.D. Vance, expanding enforcement in known fraud hotspots, and increasing scrutiny of providers suspected of abusing federal healthcare programs. They describe these efforts as essential to making the vision of aging in place sustainable.
Gingrich and Jindal also address the administration's six-month hospice enrollment moratorium, which they view as an opportunity to strengthen the system. They argue that the objective should not be to repeatedly extend temporary restrictions, but to use this period to improve provider screening, ownership verification, and oversight so that legitimate providers can continue expanding access to care. Success, they write, should be measured by whether the system becomes strong enough that moratoria are no longer needed.
The authors point to a deeper challenge in the current oversight structure. The federal government provides most of the funding for these programs, but oversight responsibilities are divided among states, contractors, accrediting organizations, and multiple federal agencies. When hundreds of providers operate from the same address, suspicious ownership structures persist for years, or known fraud hotspots continue to expand unchecked, it should be clear who is responsible for identifying and investigating those risks.
To address these issues, Gingrich and Jindal recommend strengthening provider enrollment standards, verifying the true owners behind home health and hospice companies, and improving coordination among federal and state oversight agencies. They also call for modernizing fraud detection systems by looking not only at suspicious providers but also at suspicious patterns of beneficiary enrollment and movement across multiple providers. They suggest that artificial intelligence systems could greatly assist in this effort.
Finally, the authors propose that seniors should receive clear notification whenever they are enrolled in home health or hospice services, making it far more difficult for fraudulent operators to exploit beneficiaries without their knowledge. With America's aging population, they argue, the need for home-based care will only grow, and protecting the integrity of these programs is essential to ensuring that seniors can age with dignity and independence.