Four months ago, the Department of Government Efficiency launched "Defend the Spend," a system requiring written payment justification from both grant recipients and federal grant offers before payments could be authorized.

Now, in response to the fraud scandal unfolding in Minnesota and many other states, DOGE at HHS has launched "Defend the Spend Premium," now requiring receipts, and, if eligible, the subrecipients for specific states and programs before they can be released.