WEST PALM BEACH — Governor Ron DeSantis announced a sweeping Medicaid integrity initiative that freezes enrollment for certain high-risk provider categories and requires every active Medicaid provider in Florida to revalidate credentials and identities or face removal from the program.
“Today, we announced major actions to strengthen the integrity of Florida’s Medicaid program and crack down on fraud,” said 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.”
The initiative includes a pilot program with SentiLink, a fraud detection firm that will help the Agency for Health Care Administration screen providers for stolen identities, synthetic identities and hidden ownership structures before taxpayer dollars are lost. AHCA has also 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.
AHCA Secretary Shevaun Harris framed the effort as a defense of the state’s most vulnerable residents. “The Medicaid program exists to meet the health care needs of pregnant women, children, seniors, and some of our most vulnerable populations,” Harris said. “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 announcement aligns Florida with a broader federal push. DeSantis noted that Medicaid fraud has become a growing national concern, citing major fraud investigations in other states and recent efforts by the Trump administration and the Centers for Medicare & Medicaid Services to strengthen provider screening and remove fraudulent actors from Medicaid programs. Florida has reduced spending for two consecutive years, cut debt and maintained a AAA credit rating.
Beyond the enrollment freeze and revalidation, AHCA will deploy additional claims-monitoring tools to identify potentially fraudulent billing practices and coordinate with state partners on investigations, enforcement actions and victim protection efforts. The governor’s office described the initiative as one of the most significant anti-fraud efforts undertaken by the state.
All active Florida Medicaid providers will be required to complete the statewide revalidation process; those who fail to comply or do not meet program requirements will be removed from the Medicaid program.