COLUMBUS, OH — Ohio Governor Mike DeWine signed Executive Order 2026-01D today, greenlighting immediate emergency rules for the Ohio Department of Medicaid (ODM) designed to crack down on healthcare program fraud, waste, and abuse.
The executive order allows state Medicaid officials to implement a more stringent, frequent revalidation process targeting providers flagged as high-risk for fraudulent activity. The move directly delivers on a policy commitment DeWine made in a May 1 letter to the federal Centers for Medicare & Medicaid Services (CMS) pledging that Ohio would partner with the Trump administration to fortify program integrity.
New Enforcement Mechanisms Effective Immediately
Operating under the authority of Ohio Revised Code, ODM will immediately amend the Ohio Administrative Code to enact four major policy changes:
- Purging Inactive Providers: Ohio Medicaid is now authorized to terminate provider agreements for any Medicaid provider that has not actually delivered services or billed the state program in over a year.
- Frequent Revalidation: Providers identified as operating at a higher risk for committing fraud will be required to revalidate their enrollment more frequently to prove compliance with program rules.
- Mandatory Recredentialing: The Medicaid Director now holds the authority to require specific providers to undergo recredentialing whenever deemed necessary.
- Moratorium Application Enforcement: The state can now deny a provider’s enrollment application if a federally approved moratorium is in place—even if the application was submitted before the moratorium technically began.
A Long-Standing Crackdown on System Fraud
The aggressive new rules build upon a multi-decade legislative and investigative focus championed by DeWine. His direct oversight of the state’s anti-fraud pipeline began in 2011 during his tenure as Ohio’s Attorney General and has continued through his executive leadership as governor.
According to state data, Ohio’s comprehensive enforcement efforts since 2011 have yielded substantial results:
- More than 2,300 Medicaid fraud indictments handed down.
- Over 2,200 criminal convictions secured.
- More than $644 million in fraudulent payments recovered and returned to taxpayers.
The emergency regulations enacted today formally codify the sweeping fraud prevention initiatives Governor DeWine previewed to the public last week, effectively modernizing the state’s screening system to intercept bad actors before state funds are disbursed.
