Trump Administration Requires States to Strengthen Medicaid Provider Revalidation

The Trump administration is directing states to improve their review of Medicaid providers as part of an effort to reduce improper payments in the program. On April 21 the administrator of the Centers for Medicare and Medicaid Services announced that states will be required to develop stronger plans for revalidating providers.

By law states must revalidate enrollment at least every five years, a process that verifies medical licenses, checks compliance with state and federal laws, screens against exclusion lists and confirms provider identities. Fox News reported that the federal government estimates medical providers are likely fraudulently billing about $100 billion every year.

Six months ago Minnesota was reported to have lost an estimated $9 billion to improper payments since 2018. The agency sent requests to all states seeking data on how many Medicaid providers have been revalidated. Roughly two-thirds of states have not responded while others provided incomplete information.

Among states that responded, Georgia reported 374,774 Medicaid providers with roughly 21,000 longstanding providers that have not been revalidated in the past five years. In Illinois more than 25 percent of its 222,000 providers have gone longer than five years without revalidation, including one provider that has not been reviewed in more than nine years.

Revalidation looks at license verification, death records, exclusion lists and other checks to confirm providers are legitimate. The administration previously cracked down on 447 hospices in Los Angeles for fraudulent billing, actions that revalidation is designed to identify before payments are made.

Research in Minneapolis identified providers placed on that state's exclusion list but not the federal one. One was an adult day care whose license was revoked for 35 violations including staff failing to interact with patients. An Inspector General report found that 12 percent of providers terminated for cause in one state were participating in another state's Medicaid program months later.

In California individuals were charged in April 2026 in Operation Never Say Die for $60 million in fraudulent billings through phantom hospice clinics that used stolen identities of doctors, two of whom were deceased.

In the early 2010s more than 1.6 million Medicare providers were revalidated. More than 500,000 had their status deactivated and 34,000 had their status revoked, saving taxpayers $2.4 billion. The agency has given states 30 days to submit plans for strengthening their revalidation processes.

If improved revalidation prevented even 5 percent of improper Medicaid payments, the savings would amount to billions of dollars annually. It remains to be seen how states will respond to the request for stronger review plans.