A key member of Elon Musk’s Department of Government Efficiency has met with leadership at the Centers for Medicare & Medicaid Services, the federal agency that oversees the nation’s Medicare and Medicaid insurance programs, according to internal records reviewed by ABC News.
The meeting on Thursday, which was titled “Planning Touch Base,” included a top DOGE lieutenant, Rachel Riley, along with recently Trump-appointed top brass at CMS, including Acting Administrator and Chief of Staff Stephanie Carlton, John Brooks, Deputy Administrator and Chief Policy and Regulatory Officer at CMS, and Kim Brandt, the agency’s new deputy administrator and chief operating officer, and other long-term staff at the agency, according to the records.
Sources said Riley, who is listed internally as a senior adviser at HHS and the State Department, works closely with Brad Smith, a healthcare entrepreneur and early senior DOGE member who for years has been a leading voice pushing for privatizing parts of Medicare and Medicaid.
Smith had worked in the first Trump administration to try to innovate the insurance programs, an effort that was mostly eclipsed by the pandemic.
Elon Musk leaves Blair House after a meeting with Indian Prime Minister Narendra Modi at Blair House, in Washington, Feb. 13, 2025.
Will Oliver/EPA-EFE/Shutterstock
It is not immediately clear what was discussed at the meeting. Sources added that DOGE members have been on-site at the agency’s offices since last week and have been attending meetings with senior staff, asking for access to CMS’s for payment systems.
CMS oversees health care coverage for more than 160 million through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace.
Medicaid and Medicare have long been considered a target by conservatives because of allegations of waste, fraud and abuse. A 2024 investigation by the Government Accountability Office found payment errors linked to the two programs reached over $100 billion worth in 2023. So far oversight efforts have been done internally by an HHS inspector general.
Democrats, though, worry that any “slash and burn” tactics by DOGE could inadvertently prevent people from accessing health care.
Trump has said he doesn’t want to restrict access, but rather root out fraud.
According to records reviewed by ABC News, the meeting also included Peter Nelson, recently appointed head of the CMS office overseeing Obamacare marketplaces, and Rebekah Armstrong, now leading CMS’ Office of Legislation.
Musk last week posted on X that his team would be targeting fraud at the agency.
