Governor Ron DeSantis Announces Medicaid Integrity Initiative to Crack Down on Fraud

WEST PALM BEACH, Fla.—Today, Governor Ron DeSantis announced a comprehensive Medicaid integrity initiative aimed at strengthening oversight, preventing fraud before it occurs, and ensuring taxpayer dollars are spent on care for eligible Floridians.

The initiative includes enhanced provider screening, advanced fraud detection technology, enrollment controls for high-risk provider categories, and a statewide revalidation of all active Medicaid providers.

“Today, we announced major actions to strengthen the integrity of Florida’s Medicaid program and crack down on fraud,” said Governor DeSantis. “In Florida, we work to ensure that taxpayer dollars are spent responsibly and that public programs serve the people they are intended to serve.”

Florida has long prioritized fiscal responsibility, reducing spending for two consecutive years, cutting debt, maintaining a AAA credit rating, and exposing wasteful government spending.

“The Medicaid program exists to meet the health care needs of pregnant women, children, seniors, and some of our most vulnerable populations,” said Florida Agency for Health Care Administration Secretary Shevaun Harris. “Every dollar stolen through fraudulent schemes is one less dollar available to meet the needs of those who rely on the program most. That’s why we are working harder than ever to make sure the right people get the care they need, and everyone trying to exploit this program will be stopped.”

The Governor noted that Medicaid fraud has become a growing national concern, citing major fraud investigations in other states and recent federal efforts to strengthen Medicaid program integrity. The Trump Administration and the Centers for Medicare & Medicaid Services (CMS) have called on states to increase oversight, strengthen provider screening, and remove fraudulent actors from Medicaid programs.

As part of Florida’s Medicaid integrity initiative, the Agency for Health Care Administration (AHCA) will:

Launch a pilot program with SentiLink

AHCA will partner with SentiLink to strengthen provider screening and detect sophisticated fraud schemes, including stolen identities, synthetic identities, and hidden ownership structures before taxpayer dollars are lost.

Implement enrollment moratoriums for high-risk provider categories

AHCA has imposed enrollment moratoriums on certain high-risk provider categories, including durable medical equipment suppliers and adult day care providers, while the agency strengthens screening procedures and oversight.

Conduct a comprehensive statewide provider revalidation effort

All active Florida Medicaid providers will be required to revalidate their credentials and identities. Providers who fail to comply or do not meet program requirements will be removed from the Medicaid program.

Enhance claims monitoring and enforcement efforts

AHCA will deploy additional tools to identify potentially fraudulent billing practices and work with state partners to support investigations, enforcement actions, and victim protection efforts.

Florida’s Medicaid integrity initiative represents one of the most significant anti-fraud efforts undertaken by the state and reflects Florida’s continued commitment to protecting taxpayers while ensuring Medicaid resources are available for those who legitimately need them.