CMS Administrator Dr. Mehmet Oz announced a 50-state Medicaid oversight audit with the stated goal of strengthening program integrity and identifying fraud, waste, and abuse in state Medicaid programs. As part of the effort, CMS is asking states to quickly revalidate Medicaid providers considered “high risk,” with states expected to notify CMS within 10 business days whether they will conduct the revalidation and to submit a broader two-year provider revalidation strategy within 30 days.  

The effort focuses on provider screening and enrollment, including off-cycle revalidations for high-risk providers and providers without National Provider Identifiers. CMS has framed the audit as a way to protect Medicaid by keeping fraudulent actors out of the program, while some organizations have noted that the approach could have significant operational implications for states and providers, particularly in home- and community-based services where some non-medical providers may not routinely have NPIs.