At least five states have taken steps in 2026 to restrict new Medicaid behavioral health provider enrollments as stakeholders seek to curb fraud, waste and abuse while strengthening oversight of high-risk services.
The developments come as the Trump administration aims to crack down on healthcare fraud. On June 25, the Justice Department charged 455 people, including 90 physicians, nurses and other licensed medical professionals, in connection with what it described as healthcare fraud and opioid abuse schemes.
1. Indiana
The Indiana Family and Social Services Administration implemented a temporary moratorium on new Applied Behavior Analysis provider agency enrollments, effective June 6. The CMS approved the action.
The moratorium pauses enrollment of new ABA provider agencies and changes of ownership for existing agencies under federal regulation. Individual rendering ABA practitioners may continue to enroll, and applications received before June 6 will be processed. The initial moratorium will last six months and may be extended in six-month increments.
FSSA said it will monitor service access throughout the moratorium and may grant exceptions to accredited providers in underserved regions. CMS approved Indiana’s request after determining new ABA agency enrollments represent a significant potential risk for fraud, waste or abuse.
2. Maryland
The Maryland Department of Health extended a temporary suspension on certain new Medicaid behavioral health provider enrollments amid efforts to address potential fraud, waste and abuse and ensure provider quality.
The moratorium extension runs for six months starting July 1. It applies to four behavioral health programs and services licensed under Maryland regulations: psychiatric rehabilitation programs, psychiatric rehabilitation programs, level 2.5 partial hospital programs and level 2.1 intensive outpatient treatment programs.
The pause affects providers in 10 Maryland jurisdictions: Anne Arundel County, the city of Baltimore, Baltimore County, Carroll County, Frederick County, Harford County, Howard County, Montgomery County, Prince George’s County and Washington County.
3. Minnesota
On Jan. 27, Minnesota Department of Human Services froze provider enrollment across 13 Medicaid services, including early intensive developmental and behavioral intervention, adult rehabilitative mental health services, intensive residential treatment services and peer recovery support services.
CMS pushed for Minnesota to stop new providers from enrolling in the “high-risk categories,” as well as revalidate current enrollment, according to a statement from the state agency. The pause is anticipated to last six months.
The move does not freeze client enrollment and will be open to exceptions approved by CMS.
4. Ohio
The Ohio Department of Behavioral Health implemented an enhanced review process for new behavioral health provider licensure and certification applications, including a temporary freeze on new behavioral health and rehab provider applications.
The behavioral health department said it will strengthen coordination with the Ohio Department of Medicaid, managed care organizations and the Ohio attorney general to identify and address potential fraud, waste and abuse.
On June 4, four people were charged in federal court in Ohio in what authorities described as a $30 million fraud conspiracy involving billing for children’s behavioral health services that were not provided.
5. Utah
The Utah Department of Health and Human Services has placed a temporary moratorium on new substance use disorder and mental health rehabilitation provider enrollments in the state’s Medicaid program after receiving federal approval.
The moratorium applies to new enrollments, including applications already in progress, but will not affect Medicaid members currently receiving treatment or providers already participating in the network. Utah Medicaid said it will work with managed care organizations and local mental health authorities to monitor network adequacy during the pause.
The move follows Utah’s May 1, 2026, decision to designate all substance use disorder and applied behavior analysis providers as “high-risk” under federal authority. Existing and new SUD providers will undergo additional screening, including fingerprint-based criminal background checks for all owners and operators with a 5% or greater interest and unannounced site visits.
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