NEW YORK (AP) — The Trump administration will require all 50 states to explain their plans to revalidate some of their Medicaid providers in a national escalation of anti-fraud efforts that have so far largely focused on specific states, Dr. Mehmet Oz said April 21.
Oz said during a Politico health care summit that his agency planned to ask states to “own” the problem of health care fraud with requests for states to share their strategies within 30 days.
“It's an example of what we'd like them to do to prove that they're serious about this,” Oz said onstage Tuesday. “And if you don't take it seriously, it indicates to us that we might have to take the audits that we're doing to the different states more aggressively,” he said, without elaborating.
The April 21, announcement was part of a federal campaign to tackle waste, fraud and abuse in federal Medicaid and Medicare programs that so far has mostly targeted Democratic-led states, and at least once has drawn criticism over inaccuracies in the administration’s findings.
Earlier in April, The Associated Press reported that CMS made a significant error in figures it used to help justify a fraud probe in New York. The acknowledgment raised questions about the administration’s methods and criticism that officials moved forward publicly before confirming all of the facts.
In addition to New York, CMS has approached at least four other states with investigations into potential health care fraud and halted some $243 million in Medicaid payments to Minnesota over fraud concerns. The agency also blocked new Medicare enrollments for suppliers of durable medical equipment, prosthetics, orthotics and certain other supplies for six months nationwide to address potential fraud concerns.
Federal officials also announced several arrests earlier this April tied to alleged hospice fraud schemes in the Los Angeles area.
Last month, President Donald Trump signed an executive order to create an anti-fraud task force across federal benefit programs led by Vice President JD Vance. It remains unclear whether the new Medicaid provider review effort is directly tied to that task force, though Oz has worked closely with Vance on related investigations. Asked for details on the new audit, a spokesperson for CMS said the agency was researching the AP's inquiry.
Oz defended the administration’s actions by saying some states have enrolled large numbers of providers who are not providing legitimate patient care and are instead profiting from fraud. He said the provider reviews would focus on “high risk areas,” but did not specify which areas those include.
Oz defended the administration’s actions by saying some states have enrolled large numbers of providers who are not providing legitimate patient care and are instead profiting from fraud. He said the provider reviews would focus on “high risk areas,” but did not specify which areas those include.
Minnesota Gov. Tim Walz, who has faced criticism from the Trump administration and congressional Republicans over fraud in federally funded programs, said Minnesota had already been working on revalidation efforts and improvements before receiving the federal request.
Minnesota sued CMS in February in an effort to stop the agency from withholding Medicaid funds. That case remains ongoing, though CMS later told state officials it had approved the state’s corrective action plan.
Minnesota sued CMS in February in an effort to stop the agency from withholding Medicaid funds. That case remains ongoing, though CMS later told state officials it had approved the state’s corrective action plan.
Asked during the Politico interview whether the administration’s efforts could slow or harm access to essential health care programs, Oz said he believed the opposite would happen.
“I believe this audit and others like it will save the programs we care most about,” he said.
Minnesota sued CMS in February in an effort to stop the agency from withholding Medicaid funds. That case remains ongoing, though CMS later told state officials it had approved the state’s corrective action plan.
Asked during the Politico interview whether the administration’s efforts could slow or harm access to essential health care programs, Oz said he believed the opposite would happen.
“I believe this audit and others like it will save the programs we care most about,” he said.
More than two weeks after the federal announcement, Nevada leaders said the state is already expanding its own Medicaid oversight efforts and backing the federal push.
On Thursday May 7, Nevada Governor Joe Lombardo voiced support for the CMS effort and outlined Nevada’s ongoing actions to address provider fraud and protect taxpayer dollars.
“Nevada stands strong with our federal partners and is committed to taking all actions necessary to crack down on Medicaid provider fraud,” Lombardo said in a statement. “These perpetrators are a scourge on our healthcare system and drain valuable resources from Nevadans who need them most. We do not tolerate fraud in any form and will ensure Medicaid dollars are going to legitimate providers serving our citizens.”
According to the governor’s office, Nevada expanded anti-fraud efforts through the creation of the state’s first Medicaid Inspector General within the Nevada Health Authority during the 2025 legislative session. State officials said the office focuses on independent oversight of Medicaid spending while also using artificial intelligence, fraud detection technology and biometric identity verification tools to identify suspicious claims and provider activity.
Nevada officials also said the Nevada Health Authority created several task forces with licensing units across its programs to address fraud concerns tied to Nevada Medicaid.
“As technology advances, so does the sophistication of bad actors in Medicaid, requiring us to remain vigilant in our approach to fraud,” said Stacie Weeks. “We have had to modernize our systems with new software and AI solutions for data analytics, which allows us to identify suspicious claims and fraudulent patterns before payments go out the door, saving millions in taxpayer dollars.”
Nevada Medicaid plans to submit a two-year plan to CMS outlining how the state will strengthen its provider revalidation process in response to the federal request, according to the governor’s office.
Read Governor Lombardo's letter to Dr. Oz below:
Associated Press writer Steve Karnowski in St. Paul, Minnesota, contributed to this report.
