The federal Centers for Medicare & Medicaid Services is demanding that Vermont renew its Medicaid care providers’ eligibility as part of the Trump administration’s effort to weed out fraud, waste and abuse, according to letters that Vermont Medicaid and the governor’s office received Thursday.
CMS Administrator Mehmet Oz asked all 50 states to give the federal department their two-year plans, within 30 days of the letters’ receipt, for revalidating Medicaid providers. He specifically requests that states undertake a “swift” revalidation of providers at high risk of committing fraud and submit a plan for doing so within 10 days. The governor’s office received a letter specifically addressing this “high-risk” revalidation.
The nationwide requests come on the heels of a March congressional letter targeting Vermont and nine other states and demanding information to identify Medicaid vulnerabilities to fraud, waste and abuse.
CMS requires healthcare providers who receive Medicaid funds to renew their enrollment periodically — typically every five years, though medical suppliers revalidate status every three years, according to a federal website.
In his letter, Oz wrote that revalidation can help identify where providers no longer meet criteria for Medicaid enrollment — such as professional credentials — but it is “just one component of a broader program‐integrity framework.” He noted that screening alone may not identify every instance of fraud, especially in cases where providers are indeed qualified to administer services.
A representative from Vermont’s Agency of Human Services said Monday the state was still assessing CMS’ request and working on its response. The agency was unable to answer additional questions Monday.
“The State of Vermont takes fraud, waste and abuse seriously,” wrote Ted Fisher, the communications director for the Agency of Human Services. “We are committed to administering a high-quality Medicaid program that supports the health of Vermonters and responsibly stewards taxpayer resources.”
Heightened attention to Medicaid fraud came after federal health officials accused Minnesota of paying out nearly $243.8 million in Medicaid dollars to potentially fraudulent providers in 2025.
Ongoing federal concerns about potential fraud has already caused some changes in Vermont Medicaid. In December, the state program that administers Medicaid changed how it pays for an autism therapy called applied behavioral analysis, in an effort to avoid federal inquiries. The move has left many providers of the therapy and parents of those with autism worried about the ability to access these services.
The Vermont attorney general’s Medicaid Fraud and Residential Abuse Unit has pursued a number of fraud cases. For instance, the office reached a $200,000 settlement with the Burlington mental health care provider Eden Valley in December, for submitting falsified records on Medicaid claims. In April 2025, a different investigation by the attorney general’s Medicaid fraud unit found that a Lamoille County couple had submitted false timesheets, for thousands of dollars of Medicaid claims.
