Revalidation of “High-Risk” Medicaid Providers: Early Lessons from Minnesota

The Centers for Medicare & Medicaid Services (CMS) requested state Medicaid directors submit a two-year provider revalidation strategy to prevent revalidation of “high-risk” providers. Revalidation is the process states take to “re-screen” providers for program integrity in order for them to be allowed to bill Medicaid. The screening process is intended to identify bad actors and keep them out of the program before they can defraud it. This blog discusses Medicaid provider revalidation and how states like Minnesota are screening providers.