Welcome to the House Committee on Energy and Commerce

WASHINGTON, D.C. – Congressman Richard Hudson (NC-09), Chairman of the Subcommittee on Communications and Technology, delivered the following opening statement at today’s hearing titled Evaluating FirstNet: Performance, Accountability, and Reauthorization.

Subcommittee Chairman Hudson’s opening statement as prepared for delivery:

“Good morning, and welcome to today’s legislative hearing on the First Responder Network Authority, or FirstNet. FirstNet’s authorization expires at the beginning of next year, and it is this Committee’s duty to reauthorize the program before it expires. In the process, we should examine FirstNet’s activities since its creation 15 years ago and make any changes necessary to improve its performance. The future of public safety relies on safe resources like FirstNet, so thank you all for joining us to ensure our country is taken care of in times of need.

“During the horrific terrorist attacks on September 11, 2001, first responders from different agencies found they could not communicate with each other because they used different radio systems, and overloaded networks prevented communications from going through. In the aftermath of these attacks, Congress stood up the 9/11 Commission, which made recommendations to prepare for and guard against future attacks. One of those recommendations led to Congress establishing FirstNet, a nationwide broadband network specifically built for public safety.

“FirstNet was allocated 20 megahertz of spectrum and $7 billion to build out the network in all 50 states and the territories. In 2017, AT&T was selected to deploy this network. Shortly after, FirstNet began providing priority and preemption. During a crisis when there is increased network traffic, non-FirstNet AT&T subscribers will be removed from the priority line to ensure first responders can always make the call. On December 20, 2023, the FirstNet Authority verified the initial nationwide buildout of the network.

“However, the successful buildout of this network does not mean it has not faced challenges. Since 2014, the Department of Commerce Office of Inspector General (OIG) has issued 21 reports regarding significant concerns about FirstNet and the deployment of the nationwide public safety broadband network, its operational responses, and other administrative matters.

“Several of these reports highlight contract oversight shortcomings, resulting in modified buildout objectives that jeopardize first responders’ ability to do their jobs. Other reports indicate a failure of the network to adequately respond to a natural disaster, and that a senior official at FirstNet interfered with the OIG’s investigations and retaliated against whistleblowers who cooperated with the OIG.

“This Committee’s work over the last several months has also identified a consistent and troubling finding: the ambiguous language regarding FirstNet’s independence—while simultaneously placing it directly within an Executive Branch agency—has created confusion and strife for all parties involved when trying to manage this program. To ensure the long-term success of FirstNet, it is imperative there is clear and consistent leadership.

“This leadership must be able to work hand-in-hand with the FirstNet board, not against it. I would like to emphasize that this draft legislation does not, in any way, remove the statutory requirement to have a Board, or their responsibilities to the First Responder Network Authority. The Board is a valuable component of FirstNet and crucial for ensuring the experience and needs of first responders and the general public, not government bureaucracy, are reflected in the direction of the network.

“Additionally, we must ensure that this network can evolve along with the technological landscape. Networks of 15 years ago are different than those of today and could be even more different 15 years from now. For the benefit of first responders, FirstNet should have the statutory flexibility to incorporate new network technologies to provide the most advanced service that public safety requires.

“I want to be clear, FirstNet has succeeded despite the challenges it’s faced, and I would like to commend AT&T for building a nationwide safety communications network, making it a success and continuing to build it out and improve for the safety of others, and being the only ones to take it on. Congress is here to evaluate this program to ensure its long-term success for our first responders. Today is the first step to reauthorize the program.

“With FirstNet’s statutory authority set to expire in 2027, it’s time for Congress to assess FirstNet’s progress and ensure that we provide a governing structure that sets up FirstNet to succeed in the future.

“Today, we will hear from our witnesses who are directly involved with FirstNet about the current state the network, and how the legislation before us will strengthen the First Responder Network Authority.”

WASHINGTON, D.C. – Today, Congressman John Joyce, M.D. (PA-13), Chairman of the Subcommittee on Oversight and Investigations, led a hearing titled Common Schemes, Real Harm: Examining Fraud in Medicare and Medicaid.

“What’s happening in Minnesota’s Medicaid program is deeply concerning and requires robust Congressional oversight; however, it is just the tip of the iceberg,” said Chairman Joyce. “Medicare and Medicaid fraud has been occurring in communities across the U.S. for decades, diverting necessary resources from patients in need. It is our duty to protect these programs for our most vulnerable Americans.”

Watch the full hearing here.

Below are key excerpts from today's hearing:

Congressman Russ Fulcher (ID-01): “I’m from the state of Idaho—which, sometimes, may not be the first state you think about when there might be fraud, but that is kind of the basis of my question. Have you noticed any trends where states might get targeted or regions might get targeted as a function of potentially them having a lower barrier for entry, or maybe perceived as not being as likely to be audited?” Ms. Gay: “Absolutely. We talk a lot in the industry how [fraud] can be regionally generated. It tends to start in one particular area, and then I don’t know if they’re all hanging out, talking to each other, or how that spreads, but it does tend to start in certain populations and then branch out from there based on controls.” Mr. Fulcher: “What if the bad actor is a foreign actor? How much of that do you see? And if so, what kind of a challenge does that bring to potentially pursuing that fraud, if it’s perpetrated by a foreign actor?” Ms. Wooten: “Certainly, states have seen both fraud cases perpetrated by foreign and by U.S. citizens or people in the U.S., and from our perspective, as being a Medicaid Fraud Control Unit, it makes no difference. We look at allegations, try to identify whether there is something we can do about them? Is the dollar amount something we can pursue? Are we going to be able to get value back for the Medicaid program? Do we have the laws in place to prosecute whatever type of fraud is referred? And we move forward with that investigation.”

Congressman Dan Crenshaw (TX-02): “So what’s the solution here? I mean, some argue stronger oversight would actually threaten access to care, but based on your experience, what actually happens to access when fraud is not controlled? Who bears the brunt of this?” Ms. Gay: “I think there’s certainly the patient-harm attribute you mentioned—you know, not getting the care that you need. […] We dealt with some cases with ACA enrollments, and by the time we verified with CMS that those were eligible recipients, the health plan was already on the hook for $1, $2, $3 million. Were these patients even receiving the care? In some cases, yes. In other cases, they had no idea that they were in a facility for such treatment. […] Now you have somebody that doesn’t even have that challenge, but that is now on their record. And even worse—those that do, that are getting subpar treatment at a very exorbitant rate and still not getting better.”

Congressman Buddy Carter (GA-01): “Auditors found 112 hospice providers operating out of a single physical address. 112...holy cow. As a result, hospice agencies in LA County alone likely overbilled Medicare by $105 million in just one year. […] It looks like it’s a problem in a lot of different places. And that’s why I want to ask you, Ms. Wooten, have you seen instances of copycats where fraudsters see a successful fraud scheme happening in one location, so they try to replicate the same fraud elsewhere?” Ms. Wooten: “Absolutely. We definitely see replicated fraud schemes in hospices; an excellent example. I share your concerns about home health and hospice because I owned a home health agency for many years, and I didn’t even choose to be a hospice because there were specialized agencies that could handle that part, and we would refer to them under the right circumstances. What we now see, though—hospices who are admitting patients who are not terminally ill, patients who don’t know they were put on hospice, patients who maybe aren’t getting treatments that they need, because the hospice philosophy, as you know, is for comfort care, not for treating illnesses. We have seen the same thing in Utah that the hospices have exploded. Now, I’m not saying they’re all fraudulent either, but absolutely; fraudsters learn from fraudsters and it’s an area we have to investigate.”

WASHINGTON, D.C. – Congressman John Joyce, M.D. (PA-13), Chairman of the Subcommittee on Oversight and Investigations, delivered the following opening statement at today’s hearing titled Common Schemes, Real Harm: Examining Fraud in Medicare and Medicaid.

Subcommittee Chairman Joyce’s opening statement as prepared for delivery:

“Good morning, and welcome to today’s hearing entitled ‘Common Schemes, Real Harm: Examining Fraud in Medicare and Medicaid.’

“Recent criminal prosecutions and continued allegations of fraud in the State of Minnesota’s Medicaid and other benefits programs have shone a spotlight on how vulnerable these programs are. Americans are outraged. Any amount of waste, fraud, or abuse of resources and taxpayer funds is too much, but it is particularly alarming when it happens on a scale as large as what is being uncovered in Minnesota.

“What’s happening in Minnesota’s Medicaid program is critical and worth discussing, but it is just the tip of the iceberg — Medicare and Medicaid fraud is common, happening nationwide, and has been egregious for decades.

“Some estimates place annual Medicare and Medicaid fraud losses at $100 billion annually. This is only a conservative estimate because fraud can only be accounted for if it is detected.

“The Government Accountability Office placed Medicare on its inaugural ‘high-risk’ list in 1990, and it has remained there ever since. Medicaid also joined Medicare on the ‘high-risk’ list in 2003. The Department of Health and Human Services Office of Inspector General has also sounded the alarm on the unsustainable rates of waste, fraud, and abuse in Medicare and Medicaid.

“Here are just a few examples of some of the fraud schemes we are seeing in these programs:

“In New York, an adult day care owner defrauded Medicaid over $68 million through illegal patient referral kickbacks and bribery schemes.

“In Arizona, a man based in Pakistan and the United Arab Emirates allegedly billed Arizona Medicaid $650 million in a fraud scheme targeting the homeless and Native Americans seeking substance abuse treatment.

“In another case last year, seven defendants across Arizona and Nevada were charged in connection with an alleged $1.1 billion Medicare fraud scheme for medically unnecessary amniotic wound allografts, or skin substitutes.

“Just a few weeks ago, a Florida laboratory owner pleaded guilty to $52 million in medically unnecessary genetic tests billed on behalf of Medicare beneficiaries.

“In all these cases, patients suffer from unnecessary, inadequate, or a complete lack of medical care. In other cases, patients are unknowingly victims of identity theft or misleading marketing practices perpetrated by fraudsters.

“And as highlighted in one of the above examples, nation-states and overseas criminal gangs are also targeting Medicare and Medicaid. Recent criminal indictments and convictions show the trend is getting worse and exemplify the scale of the fraud. It has been said that health care fraud is becoming easier and more lucrative than the illicit drug trade.

“Patients will suffer if these health care programs cannot continue on a responsible fiscal path. It is our duty to protect these programs for our most vulnerable Americans. American taxpayers invest hundreds of billions into Medicare and Medicaid. We must do better to protect these programs from fraud that is draining them of billions of dollars annually.

“We applaud law enforcement efforts that investigate and prosecute fraud, but we can save more money by detecting and preventing fraud before it occurs, rather than paying and chasing funds after they are paid to criminals.

“I want to thank our witnesses for being here today. Your knowledge about this important topic will help us understand the challenge of Medicare and Medicaid program integrity we are facing today. As our witnesses will testify to today, these are real, legitimate fraud schemes.”

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, Congressman Jason Smith (MO-08), Chairman of the House Committee on Ways and Means, Congressman David Schweikert (AZ-01), Chairman of the Ways and Means Subcommittee on Oversight, and Congressman Vern Buchanan (FL-16), Chairman of the Ways and Means Subcommittee on Health, authored ** a letter ** to the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) requesting a meeting on the concerning evidence detailed in the letter that points to large-scale, ongoing Medicare fraud in Los Angeles County, along with what action is being taken to address the situation.

“The House Committee on Energy and Commerce has an extensive history of digging deeper into matters where program integrity has been compromised. This letter is crucial in our commitment to eliminating waste, fraud, and abuse in federal health care programs,” said Chairmen Guthrie, Joyce, and Griffith. “Republicans have spent much of this Congress furthering legislation to protect our most vulnerable Americans—especially seniors, but our work is not done. Continued oversight is crucial to uphold the integrity of programs that serve our most vulnerable populations. We applaud the ongoing work being conducted by HHS-OIG in cracking down on the fraud that has occurred, and we look forward to addressing the larger-scale scheme that is draining public resources from Americans who need these services the most.”

“Medicare home health and hospice fraud directly undermines the safety and reliability of care for America’s most vulnerable seniors. Auditors have reported an unprecedented jump in home health and hospice fraud in Los Angeles County, California – including one report showing 112 different hospices located at the same physical address. With $1.2 billion in improper payments in home health claims and the Inspector General reporting $198 million in suspected hospice fraud, Gavin Newsom’s California could just as well be another Minnesota,” said Chairman Smith. “The Ways and Means Committee will not hesitate to use our broad oversight authority to get to the bottom of this and protect taxpayers and vulnerable patients against these bad actors.”

BACKGROUND:

Evidence has strongly suggested large-scale Medicare fraud involving home health agencies (HHA) and hospice agencies in Los Angeles County, California, noting that such practices not only drain public resources but also compromise the quality of care provided to patients, especially those most vulnerable populations.

• The Centers for Medicare and Medicaid Services (CMS) found that the 2023 improper payment error rate for home health claims was 7.7 percent, or about $1.2 billion, in 2023.
• In terms of hospice care, HHS OIG reported suspected hospice fraud to be an estimated $198.1 million in fiscal year (FY) 2023.
• CMS has placed HHAs as an area of high risk for Medicare fraud.

Emerging concerns over Medicare fraud in the HHAs and hospice sector highlights heightened activity, specifically in Los Angeles County.

• From 2019 through June 2023, HHAs in the U.S. decreased from 8,838 to 8,280 (6 percent), while, at the same time, HHAs in Los Angeles County increased from 896 to 1,309 (46 percent).
• More than 1,400 new Los Angeles County HHAs enrolled in Medicare in the last five years, representing over 50 percent of all HHAs in the state of California and nearly 14 percent of all HHAs in the country.

Based on data from the March 2022 California State Auditor’s Report and from HHS on hospice ownership, Los Angeles County had more than 31 percent of the hospice agencies in the U.S. in 2022.

• There were approximately 58 million seniors in the U.S. in 2022, with Los Angeles County having approximately 1.49 million seniors (2.5 percent).
• The report highlighted indicators that included a “rapid, disproportionate growth in the number of hospice agencies” and “excessive geographic clustering of hospice agencies,” noting that 112 different licensed hospice agencies were located at the same physical address.
• State auditors in California estimated that hospice agencies in Los Angeles County likely overbilled Medicare by $105 million in 2019.

These accounts of widespread fraud occurring in Los Angeles County’s HHAs and hospice agencies have raised concerns about whether home health and hospice Accrediting Organizations (AO) are effectively examining such organizations at the time of their enrollment in Medicare.

• In November 2024, CMS issued a Quality, Safety, and Oversight memo to surveyors, reminding them to closely inspect hospices’ Medicare enrollment documents to understand changes in ownership and location, but neglecting to encourage AOs to pursue other commonsense antifraud measures.

In April 2025, HHS OIG announced that the Office of Audit Services would compile a report for FY 2026 to identify trends, patterns, and comparisons that could indicate potential vulnerabilities related to new Medicare hospice provider enrollments.

In May 2025, the Health Care Fraud Strike Force—a joint task force of federal, state, and local law enforcement agencies, including HHS OIG—** announced multiple arrests ** following a multi-year investigation into Armenian Organized Crime, which dismantled five hospices in the greater Los Angeles area.

On November 28, 2025, CMS ** announced ** the Calendar Year 2026 Home Health Prospective Payment System Final Rule, providing comments that suggest an interest in addressing the aforementioned accounts of fraud.

WASHINGTON, D.C.  – Today, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, and Congressman John Joyce, M.D. (PA-13), Chairman of the Subcommittee on Oversight and Investigations, sent a letter to the Centers for Medicare and Medicaid Services (CMS) requesting a briefing to better understand the Department of Health and Human Services’ (HHS) recent actions and ongoing work to enhance safety within the organ procurement and transplantation system. On Thursday, September 18, 2025, the Department of Health and Human Services (HHS) announced major efforts to improve safety, transparency, and efficiency within the organ procurement and transplantation system, including the decertification of an organ procurement organization (OPO) for the first time in U.S. history. According to the announcement , the decision was made “after an investigation uncovered years of unsafe practices, poor training, chronic underperformance, understaffing, and paperwork errors.” The Committee has a history of ensuring patient safety remains the highest priority in our organ procurement and transplantation system, as evident from the Committee’s work last Congress on organ transplantation and donation issues as well as its oversight this Congress. As a part of its ongoing investigation, the Committee requests that CMS respond to questions, including those related to the decertification of the OPO in South Florida and the prevalence of incidents similar to those outlined in the Health Resources and Services Administration’s (HRSA) investigative report, to ensure patient safety remains a top priority. Read the full letter HERE . “While the Committee applauds efforts taken by CMS to uphold the highest standards of care to which all OPOs are expected to adhere, HHS’s announcement decertifying the Life Alliance Organ Recovery Agency illustrates the urgency of this moment and why the subcommittee is not finished with our oversight of the organ transplant system,” said Chairmen Guthrie and Joyce. “It is our moral obligation as members of Congress to establish safeguards and prevent these harmful practices from persisting further, and we look forward to obtaining answers from the agency about the prevalence of these incidents, as well as how CMS plans to proceed with prioritizing patient safety first and foremost.” Background: During the 118th Congress, the Committee on Energy and Commerce led the passage of the Securing the U.S. Organ Procurement and Transplantation Network Act to both modernize the Organ Procurement and Transplantation Network (OPTN) and allow HRSA to institute a competitive contracting process to find the best contractors for various OPTN functions. This legislation was signed into law on September 22, 2023.  On March 20, 2024, the Committee launched an investigation into the organ procurement and transplantation system by sending a letter to United Network for Organ Sharing (UNOS) requesting information related to concerns surrounding data security and operability, patient safety and equity, and conflicts of interest.   On March 20, 2024, the Committee also sent a letter to HRSA requesting information related to implementation of the Securing the U.S. Organ Procurement and Transplantation Network Act as well as other concerns related to effective oversight and management.  On September 11, 2024, the Subcommittee on Oversight and Investigations held a hearing that focused on the implementation of reforms at the OPTN, including the need for stronger oversight and accountability as well as ongoing patient safety concerns.  During the hearing, questions were raised related to allegations of mismanagement and patient safety concerns after patients began exhibiting signs of increased neurologic function after being previously deemed suitable as an organ donation candidate. Several of these allegations, particularly those related to patient safety, were later substantiated through the findings contained in HRSA’s March 2025 report.  On March 24, 2025, HRSA’s Division of Transplantation issued a report that summarized the findings of its investigation into KYDA, the OPO now known as Network for Hope, which serves Kentucky and parts of Ohio, West Virginia, and Indiana.   HRSA’s investigation examined an “index case” and an additional 351 unique cases of authorized, not recovered (ANR) patients. This means that the patients were considered for donation after circulatory death recovery, but no organs were transplanted. The report showed that nearly 30 percent of the cases “had concerning features.” The concerning features included problems with patient-family interactions, medical assessments and team interactions, recognition of high neurologic function, and recognition and documentation of drugs in records.  On May 28, 2025, HRSA issued a corrective action plan to the OPTN, which directed the OTPN to take specific actions within a specified period of time, including developing a 12-month OPTN monitoring plan for KYDA to address concerns identified. The corrective action plan also requires the OPTN to propose policies for public comment to improve safeguards for potential donation after circulatory death (DCD) patients in the organ procurement process and increase information shared with patient families regarding DCD organ procurement.  On July 22, 2025, the House Committee on Energy and Commerce’s Subcommittee on Oversight and Investigations held a hearing examining concerning practices within our nation’s organ procurement and transplant system that were identified by HRSA’s investigation.  On September 12, 2025, the Committee sent a bipartisan letter to HRSA requesting a briefing on its ongoing oversight of patient safety in our nation’s organ procurement and transplant system. ###

WASHINGTON, D.C. – Yesterday, Congressman John Joyce, M.D. (PA-13), Chairman of the Subcommittee on Oversight and Investigations, and Congressman Gary Palmer (AL-06), Chairman of the Subcommittee on Environment, sent a letter to Gene Dodaro, the Comptroller General of the Government Accountability Office (GAO), requesting an assessment of available or emerging technologies and materials that could be used to supplement critical minerals in semiconductors. “Critical minerals such as lithium, cobalt, and rare earth elements are essential for technologies used in many sectors of the economy, including energy, transportation, national defense, health care, and consumer electronics,” said Chairmen Joyce and Palmer . “These minerals are vulnerable to supply-chain disruptions for several reasons, including U.S. reliance on foreign sources, as well as the rapid growth in demand for critical minerals in the U.S. and abroad.” CLICK HERE to read the full letter. The letter asks the GAO to examine: The status of domestic technologies and supplemental materials, such as critical minerals found in mine waste, tailings, or reclaimed from end-of-life batteries and electronic waste, that can serve as substitutes for foreign-sourced critical minerals from non-allied nations needed for semiconductors and energy grid or power electronics, including impacts on material and product performance. Key technological challenges to the development or adoption of these domestic supplemental and materials to advance the diversification of U.S. critical mineral sources. BACKGROUND: In May, the Subcommittee on Oversight and Investigations held a hearing on ways to enhance our critical mineral supply chains. Energy and Commerce Committee Republicans are committed to strengthening our critical mineral supply chains and finding solutions to reduce our reliance on foreign sources, particularly when it comes to foreign adversaries like China. The Trump Administration has also worked hard to bolster these supply chains. Critical minerals are essential to American technologies and industries, and finding innovative domestic solutions that can contribute to our independence from non-allied nations is essential as we work to onshore American innovation and strengthen our national security. ###