Musk’s DOGE Reportedly Digging Into Medicare Payment System

Elon Musk’s Department of Government Efficiency (DOGE) has reportedly gained access to Medicare’s payment system.

Representatives from the newly-created department have been working at the Centers for Medicare and Medicaid Services (CMS), getting into the agencies’ payment and contracting systems, the Wall Street Journal (WSJ) reported Wednesday (Feb. 5).

Sources told the WSJ DOGE employees have been on site at CMS all week, looking at the systems and the spending flowing through it to root out fraud and waste.

Musk acknowledged the efforts on his X platform, writing: “Yeah, this is where the big money fraud is happening,” in reference to the Medicare agency.

While DOGE’s work has shaken up other government offices in the last two weeks, the WSJ notes that CMS is an especially “politically and economically sensitive agency,” the center of the U.S. healthcare economy and the source of 22% of federal spending.

Its payment structure, the report adds, is complicated, with several layers of contractors and companies. For example, much of Medicare goes through private insurers, who are paid by the government, while Medicaid is overseen by both state and federal officials.

A CMS official said that the agency has “two senior agency veterans who are leading the coordination with DOGE,” and that CMS leaders were “taking a thoughtful approach to see where there may be opportunities for more effective and efficient spending in line with meeting the goals of President Trump.”

One source said that — as far as they know — DOGE hasn’t gotten access to personal health information of Medicare or Medicaid enrollees, or the CMS accounting system. DOGE’s access is “read-only,” meaning that its affiliates can’t make changes to the systems, the source added.

The news follows a WSJ report from Tuesday (Feb. 4) that Musk and his allies were conducting an “operational efficiency assessment” of the Treasury Department’s payment systems, but — as with CMS — these workers had “read-only” access.

As PYMNTS wrote earlier this week, DOGE’s efforts raise some serious questions, such as: How does having access to these databases differ from controlling who gets paid and when?

“The legal authority to stop payments. No, absolutely not,” QED investor partner Amias Gerety told Karen Webster earlier this week.

“They don’t have that legal authority,” added Gerety, himself a veteran of the Treasury under the Obama White House. “But this is a system; it’s a computer system. So, if you control the computer system, you control the payments. Now, is that illegal? Yes, it’s definitely illegal and it’s worth taking a step back.”