Gov. Ron DeSantis on Friday announced a Medicaid integrity initiative aimed at tightening oversight of Florida’s Medicaid program and preventing fraud before taxpayer dollars are spent.
The initiative, announced in West Palm Beach, includes enhanced provider screening, new fraud-detection technology, enrollment restrictions for certain high-risk provider categories and a statewide revalidation of all active Medicaid providers.
DeSantis said the effort is intended to ensure Medicaid funds are used responsibly and directed toward eligible Floridians who rely on the program. Medicaid provides health coverage for low-income children, pregnant women, seniors and other vulnerable populations.
“In Florida, we work to ensure that taxpayer dollars are spent responsibly and that public programs serve the people they are intended to serve,” DeSantis said.
The Agency for Health Care Administration, which oversees Florida’s Medicaid program, will partner with SentiLink on a pilot program designed to strengthen provider screening. The technology will be used to detect potential fraud involving stolen identities, synthetic identities and hidden ownership structures. The agency has also imposed enrollment moratoriums on some high-risk provider groups, including durable medical equipment suppliers and adult day care providers, while it strengthens oversight procedures.
All active Florida Medicaid providers will be required to revalidate their credentials and identities. Providers that fail to comply or do not meet program requirements could be removed from the program.
The initiative also calls for enhanced claims monitoring and coordination with state partners on investigations and enforcement actions.
