OPM director Scott Kupor told Newsmax the agency found $500 million in fraud and waste within federal employee health plans and will verify 100% of enrollees for the first time. The program covers about 8 million people and costs roughly $80 billion annually. The $500 million includes $237.7 million in claims stopped before payment, $271.9 million prevented through billing and policy changes, and $21.9 million recovered after payment for 2025. OPM's action follows a joint announcement with the White House Task Force To Eliminate Fraud and comes amid broader federal efforts to tighten eligibility and curb improper spending.
OPM Says It Found $500M In Waste, Will Verify 100% Of Federal Health Plan Enrollees
Scott Kupor, director of the Office of Personnel Management (AP)
Scott Kupor, director of the Office of Personnel Management (OPM), told Newsmax that the agency identified $500 million in fraud and waste in federal employee health coverage plans and will next verify every enrollee's eligibility.
What OPM Found And What Happens Next
Speaking on "Ed Henry: The Big Take," Kupor described a long-neglected effort to strengthen oversight of the health insurance program that serves roughly 8 million federal employees and retirees and costs about $80 billion annually.
"We run about an $80 billion healthcare program," Kupor said. The $500 million figure represents "a little more than half [a] percent," he added, stressing there is more work to be done.
Those savings were initially flagged by OPM's insurance carriers. In the next phase, OPM will review claims data to flag anomalies—for example, physicians prescribing drugs at rates 10 times the national average—and will, for the first time, verify 100% of enrollees on its rolls.
"We're going to actually verify 100% of the enrollees on our books," Kupor said, calling such a comprehensive verification unprecedented in the program's history.
Breakdown Of The $500 Million
The $500 million total aligns with a joint announcement from OPM and the White House Task Force To Eliminate Fraud for calendar year 2025:
- $237.7 million: Claims stopped or reduced before payment
- $271.9 million: Losses prevented through billing and policy changes
- $21.9 million: Post-payment recoveries
Broader Context
Host Ed Henry raised the topic of Vice President JD Vance's wider anti-fraud campaign, which recently canceled subsidies for roughly 760,000 Affordable Care Act enrollees deemed fraudulent or ineligible and projects about $2.2 billion in savings.
Kupor described the OPM effort as "the first full-scale effort that I've ever seen," framing it as a matter of taxpayer stewardship. "Every single dollar we spend in the federal government is not our money. This belongs to the American taxpayers," he said.
OPM's next steps—data-driven claims reviews and full eligibility verification—could further reduce improper payments and strengthen program integrity, though the effort will be administratively complex and closely watched by stakeholders.
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