Medicaid RAC Improvement Act of 2026

Key Points

• This bill updates the way the government finds and gets back Medicaid money that was paid out by mistake. It focuses on a program where outside contractors check medical bills to make sure the government did not pay too much or too little for healthcare services.
• States would no longer be allowed to skip these audits after the year 2029. Right now, some states have special permission to avoid these reviews, but this plan would require every state to participate to ensure tax dollars are being spent correctly across the whole country.
• For the first time, these audits would also have to look at private insurance companies that manage Medicaid plans for the states. These private companies would have to either do their own reviews for payment errors or let the state auditors do it for them.
• The government would be required to send a report to Congress every year showing exactly how much money was recovered in each state. This report would also list the most common ways states are losing money and offer suggestions on how to fix those problems.
• To help states that are struggling to start these audit programs, the government will study why it is difficult for them and launch a five-year test project. This project will look for better ways to pay the auditors and help cover the initial costs of setting up the system.

Impact Analysis

Govbase has not yet run an impact analysis on this legislation.