Bill · H.R. 8804· House(119-HR-8804)
Medicare Payment Integrity Enhancement Act of 2026
- Introduced
- 5/13/2026
- Last activity
- 5/13/2026 — Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Sponsored by
- Lloyd Smucker
- Cosponsors
- None
- Introduced
- In Committee
What this bill would do
This bill, known as the "Medicare Payment Integrity Enhancement Act of 2026," seeks to amend title XVIII of the Social Security Act. It authorizes the Secretary of Health and Human Services to enter into contracts with recovery audit contractors to perform prepayment reviews of Medicare claims. The legislation establishes a system where contractors are paid based on a methodology that considers the amount of improper payments prevented. It also directs the transfer of funds from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund to the Centers for Medicare & Medicaid Services Program Management Account. Additionally, the Secretary is required to issue specific rules regarding payment and savings methodologies within one year.
Yes· 3 of 5
Does this reduce what the federal government spends?+4
The bill aims to reduce improper payments through a new prepayment review process.
Would people over 65 be better off under this?+2
The bill aims to protect Medicare funds through increased payment integrity and review.
Would retired people be better off under this?+2
The bill focuses on protecting the solvency and accuracy of the Medicare program which retirees rely on.
The opposite
Does this put more money into Medicare, the health coverage for people over 65?-3
The bill directs the transfer of sums from the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds to a program management account.
Who it would affect, and how
Potential Positive Impacts for People
-
Prevention of Improper Payments: The bill aims to prevent improper payments from being paid out under Medicare through a new prepayment review process (Section 2(a)(1)(D)(i)).
-
Incentivized Accuracy: The payment methodology for contractors is designed to incentivize the "timely and accurate" prevention of improper payments (Section 2(a)(1)(D)(ii)).
-
Balanced Focus: The bill directs that the prevention of improper payments should occur "without a disproportionate focus on particular types of claims" (Section 2(a)(1)(D)(ii)).
Potential Negative Impacts for People
-
Potential Delay in Payments: The bill introduces "prepayment review of claims for payment," which creates an exception to the standard timing of when payments shall be made (Section 2(a)(1)(A) and (B)).
-
Use of Trust Funds: The Secretary will transfer sums from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund to the Centers for Medicare & Medicaid Services Program Management Account to fund these contractors (Section 2(a)(5)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Retirees+2Good For Seniors+2Good For Low Income Households+1
- Economy And Finance
- Reduces Government Spending+4
- Healthcare
- Increases Medicare Funding-3
- Social Issues And Justice
- Improves Social Security+2
- 5/13/2026
- Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Introduced in House