COLUMBUS, Ohio — Ohio Governor Mike DeWine signed Executive Order 2026-01D Monday to allow the Ohio Department of Medicaid (ODM) to implement emergency rules to require more frequent revalidation of providers identified as higher-risk for committing fraud.
Since DeWine’s direct oversight of Medicaid Fraud Control Unit investigations, prosecutions and referrals began in 2011 during his time as Ohio Attorney General — and continuing under his leadership as governor — the state 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.
The governor 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 the Centers for Medicare and Medicaid Services (CMS) on May 1 committing Ohio to partnering with the federal administration and using a more stringent revalidation process to better prevent fraud.
What the Executive Order Does
Under the authority of Ohio Revised Code Sections 5164.02, 5164.32 and 5164.33, ODM will immediately amend Ohio Administrative Code rules to:
- Permit Ohio Medicaid to terminate provider agreements of Medicaid providers that have not provided Medicaid services or billed the Medicaid program in more than one year;
- Require Medicaid providers at higher risk for committing fraud to revalidate enrollment more frequently to confirm compliance with Medicaid program rules;
- Allow Ohio Medicaid to require certain Medicaid providers to recredential as determined necessary by the Medicaid Director; and
- 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.
Media contacts: Dan Tierney, 614-644-0957; Lauren Niner, 614-644-0957.
— Press Release
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