The stated goal of DOGE’s actions, per a press release from a White House spokesperson to the on Thursday, is “slashing waste, fraud, and abuse.”
As I indicate in my story published Friday, these three terms mean very various things on the earth of federal budgets, from errors the federal government makes when spending money to nebulous spending that’s legal and approved but disliked by someone in power.
Lots of the latest administration’s loudest and most sweeping actions—like Musk’s promise to finish the entirety of USAID’s varied activities or Trump’s severe cuts to scientific funding from the National Institutes of Health—may be said to focus on the latter category. If DOGE feeds government data to large language models, it would easily find spending related to DEI or other initiatives the administration considers wasteful because it pushes for $2 trillion in cuts, nearly a 3rd of the federal budget.
However the proven fact that DOGE aides are reportedly working within the offices of Medicaid and even Medicare—where budget cuts have been politically untenable for many years—suggests the duty force can be driven by evidence published by the Government Accountability Office. The GAO’s reports also give a clue into what DOGE may be hoping AI can accomplish.
Here’s what the reports reveal: Six federal programs account for 85% of what the GAO calls improper payments by the federal government, or about $200 billion per 12 months, and Medicare and Medicaid top the list. These make up small fractions of overall spending but nearly 14% of the federal deficit. Estimates of fraud, through which courts found that somebody willfully misrepresented something for financial profit, run between $233 billion and $521 billion annually.
So where is fraud happening, and will AI models fix it, as DOGE staffers hope? To reply that, I spoke with Jetson Leder-Luis, an economist at Boston University who researches fraudulent federal payments in health care and the way algorithms might help stop them.
“By dollar value [of enforcement], most health-care fraud is committed by pharmaceutical corporations,” he says.
Often those corporations promote drugs for uses that aren’t approved, called “off-label promotion,” which is deemed fraud when Medicare or Medicaid pay the bill. Other varieties of fraud include “upcoding,” where a provider sends a bill for a dearer service than was given, and medical-necessity fraud, where patients receive services that they don’t seem to be qualified for or didn’t need. There’s also substandard care, where corporations take money but don’t provide adequate services.
