The Trump administration plans to ask all 50 states to revalidate Medicaid providers in high-risk areas as part of an effort to reduce fraud, according to multiple reports. Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz announced the initiative at Politico's Health Care Summit in Washington D.C.
Key Takeaways
The Trump administration plans to ask all 50 states to revalidate Medicaid providers in high-risk areas to combat fraud. CMS Administrator Mehmet Oz announced the audit initiative at Politico's Health Care Summit.
- CMS will request states to submit a plan for provider revalidation within 30 days
- High-risk areas include unlicensed individuals and unsupervised settings
- The move follows a $259 million Medicaid payment pause in Minnesota due to fraud concerns
- Fox News reports Oz sent letters to governors demanding immediate action
The audit will be announced this week and states will have 30 days to submit a plan to CMS outlining how they will revalidate providers, as reported by Reuters. The focus is on high-risk areas involving unlicensed individuals operating in unsupervised settings. Oz emphasized the need for additional audits to ensure legitimate services are being provided.
The move follows a recent pause of $259 million in deferred Medicaid payments to Minnesota after an audit revealed potential fraud, according to Reuters. Fox News reports that Oz sent letters to all 50 governors demanding immediate action within days. The letters specify a 10-day window for states to commit to revalidation and a separate 30-day deadline for submitting a broader strategy.
The initiative targets providers with less rigorous enrollment standards, particularly those operating without National Provider Identifiers (NPIs). According to Fox News, Oz warned that failure to comply could impact evaluations of fraud likelihood in each state. The push comes amid heightened focus on large-scale Medicaid fraud cases, including Minnesota's $250 million 'Feeding Our Future' scheme.
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