Trump expands Medicaid fraud crackdown nationwide, asks states to explain provider checks

States are being asked to justify how they screen and recheck Medicaid providers, a nationwide move that could lead to tighter eligibility checks, more paperwork and, for some providers and patients, possible coverage disruptions as Washington intensifies its fraud crackdown.

Dr. Mehmet Oz announced the effort at a health-care summit in Washington, saying the Trump administration would press all 50 states to explain their plans for revalidating Medicaid providers. States that do not comply could face more aggressive federal audits, a warning that turns what had been a scattered enforcement push into a broader test of state Medicaid oversight.

The request lands on top of existing federal rules. Under Centers for Medicare & Medicaid Services regulations, state Medicaid agencies must revalidate the enrollment of all providers, regardless of provider type, at least every five years. CMS also says Medicaid and the Children’s Health Insurance Program must have fraud-detection and investigation programs that meet federal standards, and the agency conducts focused program-integrity reviews in high-risk areas of Medicaid. The administration’s latest push appears designed to force every state to show how it meets those obligations in practice.

In the coming month, states are expected to submit plans for how they will revalidate providers. That step could force Medicaid agencies to document back-end controls, identify which provider groups are being reviewed first and explain how they catch improper claims before payments go out. The policy may also sharpen a long-running tug of war between federal oversight and state authority, especially in programs where states already guard their own administration of Medicaid closely.

Minnesota has already become a model for the kind of scrutiny Washington wants to expand. State officials said about 10 percent of providers in 13 high-risk Medicaid service areas had been evaluated and revalidated as of early April, and 5,583 providers were under review. The Minnesota Department of Human Services launched a Revalidate 2026 effort with a May 31 deadline for certain high-risk providers. That campaign underscores how the federal push could reach far beyond one state and into routine provider management across the country.

The political message is as important as the paperwork. Oz said the issue should be owned by states in both red and blue areas, signaling that the White House wants the crackdown framed as bipartisan. But for patients and providers, the immediate effect is likely to be more intense screening, more federal pressure and a wider search for improper spending in one of the nation’s largest health programs.