State

Governor DeWine signs executive order approving emergency rules on Medicaid provider revalidation

By Staff Report
Governor DeWine signed Executive Order 2026-01D letting Ohio Medicaid enforce emergency rules for more frequent provider revalidation and stronger fraud prevention.
Governor DeWine signed Executive Order 2026-01D letting Ohio Medicaid enforce emergency rules for more frequent provider revalidation and stronger fraud prevention. Getty Images

Ohio Governor Mike DeWine, Monday, signed Executive Order 2026-01D to allow the Ohio Department of Medicaid (ODM) to implement emergency rules to require more frequent revalidation of providers being identified as higher-risk for committing fraud.

Officials said since Governor DeWine’s direct oversight of the Medicaid Fraud Control Unit investigations, prosecutions, and referrals began in 2011 during his time as attorney general and continuing under his leadership overseeing Medicaid’s comprehensive work to fight fraud as governor, the State of Ohio has been responsible for more than 2,300 Medicaid fraud indictments, secured 2,200 criminal convictions, and recovered more than $644 million in fraudulent Medicaid payments.

Governor DeWine announced new Medicaid fraud prevention initiatives last week that strengthen and build upon long-standing efforts to fight fraud, waste, and abuse in the Ohio Medicaid system.

He also sent a letter to Center of Medicare and Medicaid Services (CMS) on May 1 committing Ohio to partnering with the Trump Administration and using a more stringent revalidation process to better prevent fraud.

Monday’s executive order implements emergency rules announced last week.

Under the authority of Ohio Revised Code Sections 5164.02. 5164.32, 5164.33, ODM will immediately amend Ohio Administrative Code rules to:

(1) permit Ohio Medicaid to terminate the provider agreements of Medicaid providers that have not provided Medicaid services or billed the Medicaid program in more than one year,

(2) require Medicaid providers that are at a higher risk for committing fraud to revalidate enrollment more frequently to confirm compliance with Medicaid program rules,

(3) allow Ohio Medicaid to require certain Medicaid providers to recredential as determined necessary by the Medicaid Director, and

(4) permit the denial of a provider enrollment application when a federally approved moratorium is in effect, even if the enrollment application was received but not approved before the moratorium began.