Biden’s HHS Pick Touts New Investigations into Nursing Home Fraud, Abuse Amid COVID-19

President Biden’s pick to lead the Department of Health and Human Services (HHS) late last week announced several moves to crack down on nursing home fraud and abuse in his home state.

California attorney general Xavier Becerra touted the creation of a surprise inspection program known as Operation SAFE, to be led by a new state-level division targeting Medicaid fraud and elder abuse.

Previously a bureau within the state’s Department of Justice — tasked with investigating fraud related to Medi-Cal, California’s Medicaid program — the new Division of Medi-Cal Fraud and Elder Abuse (DMFEA) will expand the state’s enforcement abilities, Becerra’s office said in a statement.


“All too often, California’s elder citizens and those with disabilities are the principal targets of bad actors,” Becerra said in the statement. “That’s why we have allocated additional resources towards establishing the California Department of Justice’s new Division of Medi-Cal Fraud and Elder Abuse. DMFEA will build upon our previous success aggressively protecting our state’s most vulnerable citizens against fraud, abuse, and neglect.”

Biden tapped Becerra in early December to lead HHS, which oversees nursing homes through its Centers for Medicare & Medicaid Services (CMS) arm. The California AG had repeatedly criticized the Trump administration’s stance toward nursing home regulation and enforcement, particularly focusing on the delayed implementation of new Requirements of Participation (RoPs) and its support for mandatory arbitration agreements for nursing home residents.

The expanded DMFEA unit will send teams of “agents and medical professionals” into Medicaid-funded nursing homes to investigate claims of abuse and neglect under Operation SAFE, according to Becerra’s office, which specifically called out the fact that 34% of California coronavirus deaths occurred in the state’s nursing homes.


“Given that the most vulnerable victims of COVID-19 are the elderly and infirm, much effort has been made to avoid exposing this population to the ravages of the pandemic,” Becerra’s office wrote. “While the motivation behind these efforts is well-intentioned, attempts to insulate the elderly from exposure may result in more isolation for those in the facility setting, leaving them more dependent on those facilities to provide appropriate care and more vulnerable to abuse and fraud.”

Despite HHS’s direct role in overseeing public health during the ongoing pandemic, Becerra’s nomination has faced roadblocks in the Senate, which must confirm all cabinet-level officials.

Echoing the overall GOP sentiment toward Biden’s pick, Republican Sen. Tom Cotton of Arkansas last month wrote an op-ed slamming Becerra as a “partisan culture warrior,” citing his support for Medicare for All and Planned Parenthood and urging the Senate to reject his nomination; Cotton and other Republicans have also questioned Becerra’s lack of direct health care experience.

Former HHS secretaries Kathleen Sebelius and Donna Shalala — who served under Presidents Obama and Clinton, respectively — urged the Senate to approve Becerra immediately in a January 28 op-ed, accusing lawmakers of kneecapping the Biden administration’s ability to fully tackle COVID-19.

The pair pointed to Becerra’s experience working on Medicare issues while serving in Congress, as well as his work to investigate fraud and abuse as California’s top prosecutor.

“As soon as possible, we need someone in that role who understands these challenges and can inspire the career public servants in the department to pull together for the fight of their lives: defeating COVID-19,” Sebelius and Shalala wrote. “Becerra is that leader.”