DOGE Turns Attention to the CMS and is Given Access to Key Systems
The Department of Government Efficiency (DOGE) staff has been provided access to key payment and contracting systems at the HHS Centers for Medicare and Medicaid Services (CMS) to look for opportunities for improving efficiency and to identify fraud and ineffective use of resources. Privacy advocates have expressed concern about the privacy risks from providing DOGE with access to CMS systems, as the agency provides health coverage to more than 160 million Americans through various programs including Medicare, Medicaid, and the Children’s Health Insurance Program.
The CMS is a natural target for DOGE due to the size of its workforce and budget and the long history of fraud in health insurance. The CMS employs more than 6,700 individuals and spent $1.5 trillion last year, which is around $22% of the federal total. Elon Musk considers the CMS to be a source of big money fraud, and DOGE staff will be taking a close look at CMS systems to identify fraud and wasteful spending. The CMS has issued a statement confirming two senior agency veterans are leading the collaboration with DOGE, one of whom is focused on policy and the other on operations. They are providing appropriate access to CMS systems. “We are taking a thoughtful approach to see where there may be opportunities for more effective and efficient use of resources in line with meeting the goals of President Trump,” said the CMS leadership in a statement.
DOGE was created by President Trump in an Executive Order on the first day of his presidency, renaming the United States Digital Service established by President Barack Obama to improve the federal government’s digital capabilities. When established, the United States Digital Service came under the Office of Management and Budget (OMB), but Trump moved it to the Executive Office of the President. The purpose of DOGE is to identify fraud and waste in an effort to cut the federal budget and modernize technology and software across the federal government. Musk was put in charge of DOGE and has recruited several young engineers who have been tasked with accessing systems to look for fraud, inefficiency, and areas where budgets can be slashed.
There is considerable concern about the privacy implications associated with the broad access DOGE has been given to key government systems and the actions of DOGE thus far. Senate Minority Leader Chuck Schumer said of DOGE, “Before our very eyes, an unelected shadow government is conducting a hostile takeover of the federal government.” A lawsuit has already been filed questioning the legality of DOGE, which argues that DOGE is a type of advisory committee that should be subject to certain federal rules and transparency requirements.
DOGE has already been provided access to the payment system of the Department of the Treasury, has effectively shut down USAID, the government’s main humanitarian and development aid agency, and attention is now focused on the CMS. There is no doubt that there is fraud and waste in CMS programs. The Office of Inspector General (HHS-OIG) frequently conducts investigations and audits and identifies fraud, overpayments, and areas where funds are not being spent appropriately. The concern about DOGE is the lack of transparency about the data being accessed, how that information will be used, the speed at which DOGE is moving, and the potential for unintentional privacy breaches given the amount of sensitive protected health information (PHI) stored in CMS systems.
