Florida is launching a widespread crackdown on Medicaid fraud. Governor Ron DeSantis announced a new integrity initiative today designed to stop scams before they happen and keep taxpayer money focused on eligible residents.
The initiative rolls out several immediate changes, including a pause on accepting new enrollments for specific high-risk health care businesses. Durable medical equipment suppliers and adult day care centers will face a temporary freeze while the state tightens its screening process.
In addition, every single active Medicaid provider in Florida will soon have to revalidate their identity and credentials. Anyone who ignores the rule or fails to meet the updated standards will be removed from the program entirely.
“Today, we announced major actions to strengthen the integrity of Florida’s Medicaid program and crack down on fraud,” DeSantis said during the announcement. “In Florida, we work to ensure that taxpayer dollars are spent responsibly and that public programs serve the people they are intended to serve.”
To catch bad actors earlier, the Florida Agency for Health Care Administration (AHCA) is teaming up with a tech company called SentiLink. This new pilot program will use advanced software to spot synthetic identities, hidden ownership structures, and stolen identities right at the front door. The state agency is also stepping up its monitoring of billing claims to catch suspicious patterns and assist law enforcement in their investigations.
Medicaid is designed to provide healthcare for vulnerable residents, including children, pregnant women, and seniors. AHCA Secretary Shevaun Harris noted that financial theft directly impacts the people who actually need the medical care.
“Every dollar stolen through fraudulent schemes is one less dollar available to meet the needs of those who rely on the program most,” Harris said. “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 state’s move lines up with a growing national push to clean up Medicaid. Recent federal guidelines from the Centers for Medicare & Medicaid Services under the Trump Administration have specifically urged states to ramp up their oversight, improve provider screening, and actively boot fraudulent actors from their systems.
READ: Doctor, Meta Exec, And Lawmakers Among 12 DeSantis Picks For Florida College Boards
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