Rep. Obernolte Demands Answers on Medi-Cal Oversight

Image November 2, 2026 Press Release WASHINGTON, D.C. Congressman Jay Obernolte (CA-23) led members of the California delegation in sending a letter to California Department of Health Care Services (DHCS) Director Michelle Baass expressing concerns over the department's oversight of the Medi-Cal program following a recent report from the California State Auditor identifying deficiencies in its efforts to investigate potentially improper billing and recover overpayments. The letter, signed by Representatives Ken Calvert (CA-41), Tom McClintock (CA-05), David Valadao (CA-22), Young Kim (CA-40), Vince Fong (CA-20), and James Gallagher (CA-01), requests information on the department's efforts to strengthen program oversight, address potentially fraudulent billing, and safeguard taxpayer dollars. According to the October 15 audit, DHCS identified approximately 28,000 Medi-Cal providers as high risk for potentially improper billing during fiscal year 2024–2025, but had not initiated referrals or investigations for more than 26,000 of them. These providers collectively accounted for at least $12 billion in Medi-Cal services during that period. The audit also found that DHCS identified more than $2 billion in provider overpayments between fiscal years 2020 and 2025, approximately $300 million of which remain unrecovered. The findings come amid additional federal scrutiny of California's Medi-Cal program. On October 20, the Centers for Medicare & Medicaid Services (CMS) announced it would defer an additional $1.2 billion in federal Medicaid payments to California over concerns regarding documentation supporting certain Medi-Cal expenditures. “Medi-Cal provides critical care to millions of Californians, and every dollar lost to fraud is a dollar that is not available to help our most vulnerable citizens access the care they need,” said Congressman Jay Obernolte (CA-23). “The California State Auditor's findings raise serious concerns about the state's oversight of this program, particularly the failure to investigate more than 26,000 providers identified as high risk for potentially improper billing. California taxpayers deserve to know that their money is being used wisely and appropriately. Stronger oversight is necessary to prevent fraud, waste, and abuse while protecting the patients who depend on this critical program.” “It’s critical that California take every measure possible to eliminate fraud in the Medi-Cal program. We owe it taxpayers to verify payments to Medi-Cal providers and ensure all of our resources are being dedicated to the actual health care needs of Californians,” said Congressman Ken Calvert (CA-41). “California’s Medi-Cal program is a critical lifeline for our most vulnerable, and every dollar lost to fraud is a dollar that can’t go toward helping those in need,” said Congressman David Valadao (CA-22). “The California Department of Health Care Services has a responsibility to properly investigate fraudulent billing and improper payments, and I urge the agency to take immediate action to strengthen program oversight, hold bad actors accountable, and ensure taxpayer funds are being used appropriately.” “Medi-Cal is supposed to be a lifeline for California’s most vulnerable, not an opportunity for fraudsters to cash in at taxpayers’ expense,” said Congresswoman Young Kim (CA-40). “The fact that California failed to investigate thousands of providers flagged for potential fraud, despite those providers accounting for $12 billion in claims, raises serious questions about the state’s oversight efforts. Every dollar lost to fraud is a dollar that could have gone toward caring for seniors, mothers, and children who depend on the services Medi-Cal provides. Californians deserve answers, accountability, and assurance that their tax dollars are going where they’re needed most.” “Medi-Cal exists to protect our most vulnerable neighbors, and every dollar lost to fraud is a dollar taken from the patients and families who depend on it,” said Congressman Vince Fong (CA-20). "$12 billion in potentially improper payments is a failure of basic oversight, and patients are the ones who pay the price for California’s mismanagement. Sacramento owes Californians real answers and immediate action to protect Medi-Cal for those who need it, and to keep it fiscally solvent for future generations.” “California taxpayers are pouring billions of dollars into Medi-Cal, and they deserve to know that money is being spent responsibly—not lost to fraud, waste, and bad oversight," said Congressman James Gallagher (CA-01). "The State Auditor’s findings raise serious questions about why thousands of high-risk providers went without further investigation and why hundreds of millions of dollars in overpayments remain unrecovered. We cannot afford to ignore these warning signs. Period. Medi-Cal must protect the vulnerable Californians who depend on it, and that starts with holding the system accountable, rooting out fraud, and ensuring taxpayer dollars go toward legitimate patient care.” Read the full letter here . ### Obernolte.house.gov Issues : Healthcare