Nevada Leads Medicaid Fraud Crackdown with New Inspector General, AI Tools

Federal officials estimate that Medicaid made $37.39 billion in improper payments in fiscal year 2025. High-profile fraud cases in Minnesota have drawn national attention. Federal prosecutors have identified 14 Medicaid-funded programs where roughly $18 billion was spent since 2018, with estimates that half or more may involve fraud in areas such as home and community-based services, autism therapy, and housing stabilization. More than 90 individuals have been charged in related fraud schemes.

In response, the Trump administration launched the Task Force to Eliminate Fraud, chaired by Vice President Vance (R) with support from CMS Administrator Dr. Mehmet Oz (R). Oz sent letters to all 50 governors, including Nevada, urging states to revalidate Medicaid providers, especially in high-risk categories, and to submit plans for stronger program integrity.

Nevada Governor Joe Lombardo (R) has pledged support for this initiative to strengthen oversight of Medicaid providers and reduce fraud, waste, and abuse. In a press release responding to Oz's letter, Lombardo stated that Nevada will not tolerate fraud and will work to ensure taxpayer dollars support only legitimate providers. Nevada has created its first Medicaid Inspector General office within the Nevada Health Authority, deployed AI and biometric tools for provider verification, and formed task forces with licensing boards. The state plans to submit a two-year compliance plan to CMS on enhanced provider revalidation.

Nevada has created its first Medicaid Inspector General office within the Nevada Health Authority. The state is using AI, biometric tools for provider verification, and task forces with licensing boards. Nevada Medicaid will submit a two-year plan to CMS on enhanced provider revalidation.

Lombardo’s response positions Nevada as an active partner with the Task Force to Eliminate Fraud.