North Dakota – Gov. Kelly Armstrong announced that North Dakota Health and Human Services (HHS) has launched a new strategy aimed at strengthening oversight of the state’s Medicaid program, preventing fraud, and improving overall program integrity.

The initiative aligns with guidance issued on April 23 by the U.S. Centers for Medicare and Medicaid Services (CMS), which directed states and territories to accelerate provider revalidation efforts and develop long-term strategies to ensure only qualified providers participate in Medicaid programs.

Armstrong said Medicaid plays a critical role for many North Dakotans, including seniors, children, and individuals with disabilities, noting that while most providers operate in good faith, stronger oversight is needed to increase accountability and transparency.

Beginning July 1, North Dakota will expand oversight of three high-risk provider categories: qualified service providers, non-emergency medical transportation providers, and 1915(i) providers. The changes will include more frequent revalidations, enhanced enrollment requirements, increased competency assessments, site visits, and a provider enrollment moratorium for certain areas.

According to state officials, these categories were selected because they are more vulnerable to fraudulent activity due to limited credentialing requirements, independent contractor structures, and service delivery in home and community-based settings.

North Dakota Health and Human Services Commissioner Pat Traynor said the department has already implemented several safeguards to reduce fraud, waste, and abuse. He also noted the creation of a new Office of Program Integrity and an Office of Performance Metrics to further strengthen oversight efforts.

Officials said Medicare-enrolled providers are not included in the new two-year strategy, as the state relies on existing federal screening and revalidation processes already in place through Medicare.