Governor Lombardo BacksFederal Efforts to Crack Down on Medicaid Provider Fraud

Governor Joe Lombardo today voiced support for recent federal efforts to strengthen Medicaid program integrity and outlined Nevada's ongoing actions to combat provider fraud and protect taxpayer dollars. This announcement is in response to a recent letter from Dr. Mehmet Oz, Administrator of the Centers for Medicare & Medicaid Services (CMS), which was sent to all 50 governors, urging states to take "swift action" to ensure that only legitimate, qualified providers are receiving public funds through Medicaid.

"Nevada stands strong with our federal partners and is committed to taking all actions necessary to crack down on Medicaid provider fraud," said Governor Lombardo. "These perpetrators are a scourge on our healthcare system and drain valuable resources from Nevadans who need them most. We do not tolerate fraud in any form and will ensure Medicaid dollars are going to legitimate providers serving our citizens."

Nevada has expanded its efforts to combat fraud, waste, and abuse, including the creation of the state's first Medicaid Inspector General within the Nevada Health Authority - an initiative spearheaded by Governor Lombardo during the 2025 legislative session. Already, this new office has elevated program integrity efforts in Nevada Medicaid by prioritizing independent oversight of Medicaid spending, deploying AI and new fraud detection technology, and biometrics for verifying provider identities. Consistent with these efforts, the Nevada Health Authority has created several task forces with licensing units across its program to address the growing threat of fraud in Nevada Medicaid.

"As technology advances, so does the sophistication of bad actors in Medicaid, requiring us to remain vigilant in our approach to fraud," said Stacie Weeks, Director of Nevada Health Authority. "We have had to modernize our systems with new software and AI solutions for data analytics, which allows us to identify suspicious claims and fraudulent patterns before payments go out the door, saving millions in taxpayer dollars."

Nevada Medicaid will submit a comprehensive two-year plan to CMS, outlining how Nevada will comply with CMS' recent request to strengthen its revalidation process with enrolled providers.

Read Governor Lombardo's letter to Dr. Oz.

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