Medicaid RAC Improvement Act of 2026

Sponsor: Gus M. Bilirakis (Republican-FL)June 24, 2026

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Introduced

In Committee

Passed One Chamber

Passed Both Chambers

Signed into Law

Referred to the House Committee on Energy and Commerce.

Medicaid managed care plans would face new audits to recover overpayments

This bill would make sure that Medicaid managed care plans are audited to find and get back overpayments. It would also improve how the government watches over programs that recover these funds, aiming to use taxpayer money correctly.

What Would Change

Today, state Medicaid programs that recover overpayments might not always include managed care plans, and states can get exceptions to these rules. States also do not have a broad requirement to report on all their payment checks. After this bill, state audit programs would have to include managed care plans, and exceptions to audit rules would end by December 31, 2028. States would also need to report annually on all their payment integrity reviews.

Key Provisions

Requires state Medicaid audit programs to review claims from managed care organizations and similar health plans.
Mandates that Medicaid managed care plans either audit themselves or allow state auditors to check for overpayments by January 1, 2028.
Extends the period for audits to cover the current government budget year and the four previous budget years.
Ends the ability for states to get exceptions from Medicaid audit program rules after December 31, 2028.
Requires the government to send annual reports to Congress on how well Medicaid audit programs are working.
Requires states to report annually on all their Medicaid payment integrity reviews.

View on Congress.gov

HR 9422 · 119th Congress · June 24, 2026 · AI Summary by gemini-2.5-flash · 9/10

Medicaid RAC Improvement Act of 2026

What Would Change

Key Provisions

Lobbying Activity