CMS Directs States To Expedite Revalidation Of High-Risk Medicaid Provider Organizations

The Centers for Medicare & Medicaid Services (CMS) sent letters to all state Medicaid agencies on April 23, 2026, directing them to conduct “swift revalidation” reviews of Medicaid provider organizations identified as high-risk for fraud, waste, and abuse. CMS instructed governors to notify the agency within 10 days whether the state will proceed with expedited revalidations and to propose a timeline for completing the reviews.

States have discretion in determining which provider organizations and professionals qualify as high-risk. CMS stated that the designation is expected to include providers without National Provider Identifiers (NPIs).

CMS also directed states to . . .