Citing widespread fraud, CMS Administrator Dr. Mehmet Oz announced a nationwide initiative requiring all 50 states to submit comprehensive two-year strategies to audit and revalidate providers participating in their Medicaid programs. The 30-day deadline for submitting those plans is soon approaching.
CMS' message to states, sent on April 23, 2026, was unambiguous about the urgency of the problem: “Corrupt individuals and organizations masquerading as healthcare providers are defrauding Medicaid, and American taxpayers, of billions of dollars each year,” diverting resources away from the low-income seniors, children, and disabled individuals who rely on Medicaid for care.
“It is urgent that action be taken immediately to address the rapid increase in fraud, waste, abuse, and corruption in Medicaid and to bar fraudulent actors from further abusing the program,” Dr. Oz wrote in the letter to states. Across the healthcare industry, FWA is estimated to cost the U.S. $760 billion to $935 billion each year, or a quarter of total expenditures.
The move was the latest in a pattern of CMS and congressional leaders ramping up pressure on state agencies and demanding stronger fraud controls. Congress is conducting active fraud investigations that have already expanded to at least 11 states. For instance, CMS recently moved to withhold $1.3 billion in Medicaid payments to California, alleging rampant fraud in the state.
CMS is particularly focused on “high-risk” providers, including those without a National Provider Identifier, which are given to doctors, nurses, hospitals, nursing homes, etc. The agency has previously aimed its sights on providers of home- and community-based services, durable medical equipment, and non-emergency medical transportation (NEMT). For these providers, including NEMT brokers and health plans, the message is clear: Provider compliance is no longer a periodic checkbox, it's an ongoing operational priority.
Compliance as an Integral Feature of Operating Infrastructure
Transportation providers, long subject to heightened scrutiny, now face an even more demanding compliance landscape—one that requires real-time monitoring, not just point-in-time reviews. That's where SafeRide Health is ahead of the curve.
SafeRide's compliance infrastructure is purpose-built for exactly this environment. The platform continuously monitors transportation providers against federal exclusion databases, state Medicaid enrollment records, and licensing authorities, ensuring that every driver and vehicle in the network meets current federal and state requirements before a single trip is dispatched. When a provider's credentials lapse, their insurance expires, or a disqualifying event occurs, SafeRide flags it immediately, preventing non-compliant providers from serving Medicaid members.
“We are laser-focused on continually ensuring that all of our transportation providers are compliant with federal and state regulations,” said SafeRide Vice President of Transportation Operations Chris Koenig. “Our number one priority is providing safe and effective transportation for members, and that means carefully tracking every transportation provider and monitoring every ride. SafeRide’s network managers meet with providers regularly to review performance metrics and member feedback, and we act immediately if there are any drops in performance or lapses in compliance.”
As states develop their revalidation strategies under the CMS mandate, states and managed care organizations (MCOs) need a partner that can document and demonstrate provider compliance at any moment. SafeRide's audit-ready reporting provides health plans with the transparency and evidence trail regulators will demand.
Failure to complete revalidation results in disenrollment, and reactivation cannot be made retroactive, meaning gaps in compliance translate directly into gaps in payment and service continuity. SafeRide eliminates that risk, giving health plans confidence that their transportation networks are fully compliant, fully documented, and fully prepared for whatever CMS requires next.
Going Above and Beyond to Combat Fraud, Waste, and Abuse
Beyond ensuring that transportation providers are fully registered and compliant with all regulations, SafeRide takes a proactive, data-driven approach to combating FWA in NEMT.
Rather than relying on retrospective audits, SafeRide embeds proactive controls throughout the transportation lifecycle. This includes real-time eligibility and benefit validation when every ride is scheduled, as well as GPS-based trip validation and route verification. SafeRide can use machine learning to detect duplicate rides, inflated mileage, and suspicious ride activity. These efforts have produced measurable results, including reductions in unnecessary utilization and improved cost efficiency.
As fraud, waste, and abuse comes under an ever-hotter spotlight, states and MCOs will benefit from organizations like SafeRide that have baked prevention and control into their infrastructure and daily operations. These efforts are not only essential to reducing and controlling healthcare costs, but they help protect NEMT benefits for the patients who rely on them to access much-needed care.