Columbus, Ohio – Ohio Governor Mike DeWine has signed a new executive order aimed at tightening oversight of Medicaid providers and strengthening the state’s ongoing fight against fraud within the healthcare system.
The order, identified as Executive Order 2026-01D, gives the Ohio Department of Medicaid authority to immediately implement emergency rules focused on providers considered to be at a higher risk for fraudulent activity. State officials said the move is part of a broader effort to crack down on fraud, waste, and abuse involving taxpayer-funded healthcare programs.
Governor DeWine announced the action after previously unveiling several new anti-fraud initiatives tied to Ohio Medicaid. The state also recently committed to working more closely with the federal government and the Trump Administration to strengthen oversight procedures connected to Medicaid provider enrollment and verification.
According to state officials, DeWine sent a letter to the Centers for Medicare and Medicaid Services on May 1 outlining Ohio’s commitment to adopting stricter provider revalidation measures designed to better identify suspicious activity before fraudulent payments are made.
New Rules Target High-Risk Providers
The emergency rules now being implemented by the Ohio Department of Medicaid will change how providers are reviewed and monitored throughout the state program.
Under the new order, Medicaid providers who have not billed the system or provided Medicaid services for more than one year could have their provider agreements terminated. Officials say the change is meant to remove inactive providers who may no longer meet program standards or who could present unnecessary risks within the system.
The order also requires providers considered more likely to commit fraud to complete revalidation more often. This process allows Medicaid officials to confirm providers continue to comply with state and federal rules governing participation in the program.
In addition, Ohio Medicaid will now have authority to require certain providers to undergo recredentialing if the Medicaid Director determines it is necessary. State leaders say the extra review process could help identify concerns earlier and improve accountability.
Another major part of the order allows Medicaid officials to deny provider enrollment applications if a federally approved moratorium is already in effect, even if the application had been submitted before the moratorium officially started.
Ohio Highlights Long Fraud Fighting Record
State officials pointed to Ohio’s long-running efforts against Medicaid fraud while announcing the executive order. According to the governor’s office, Ohio has recorded more than 2,300 Medicaid fraud indictments since DeWine first began overseeing Medicaid Fraud Control Unit investigations during his tenure as attorney general in 2011.
Authorities also reported securing around 2,200 criminal convictions connected to Medicaid fraud cases during that time. In total, the state says it has recovered more than $644 million in fraudulent Medicaid payments.
The executive order takes effect immediately as Ohio moves forward with its latest attempt to strengthen oversight and reduce fraudulent activity involving Medicaid funds.
