Bill · S. 4898· Senate(119-S-4898)
Medicaid RAC Improvement Act of 2026
- Introduced
- 6/24/2026
- Last activity
- 6/24/2026 — Read twice and referred to the Committee on Finance.
- Sponsored by
- Rick Scott
- Cosponsors
- None
- Introduced
- In Committee
What this bill would do
The Medicaid RAC Improvement Act of 2026 aims to implement recommendations from the Comptroller General to improve the Medicaid Recovery Audit Contractor program. This bill seeks to increase the identification and recovery of Medicaid overpayments. It establishes new oversight and communication requirements for the Secretary regarding State plan exceptions. The legislation also mandates the inclusion of Medicaid managed care plans within these recovery programs. Furthermore, it directs studies and demonstration projects to address barriers to State participation in these programs.
Yes· 3 of 4
Does this reduce what the federal government spends?+5
The bill increases the identification and recovery of Medicaid overpayments to improve program integrity.
Does this put more money into Medicaid, the health coverage for people on low incomes?+3
By recovering overpayments, the bill helps ensure Medicaid funds are used more efficiently for intended services.
Would households on low incomes be better off under this?+2
The bill protects Medicaid resources through better oversight of overpayments, benefiting low-income participants.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Increased oversight of overpayments: The bill requires the Secretary to establish policies to communicate the expiration of State exceptions and monitor those expirations to ensure better program integrity (Section 2(a)(2)).
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Improved transparency for Congress: The Secretary must submit annual reports to Congress detailing State-specific information, including aggregate amounts of recovered overpayments and underpayments (Section 2(a)(3)).
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Enhanced accountability for managed care: The bill requires States to ensure that Medicaid managed care organizations, prepaid inpatient health plans, and prepaid ambulatory health plans are included in payment integrity reviews (Section 3).
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Research into program efficiency: The Secretary is tasked with conducting a study to examine the effectiveness of contractor payment structures and the costs associated with starting new programs (Section 4(b)(5)).
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Support for State participation: A 5-year demonstration project will be conducted to increase the number of States establishing and implementing Medicaid RAC programs (Section 4(b)(6)).
Potential Negative Impacts for People
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Limitations on program exceptions: The bill mandates that any approved RAC exception SPA approval expiration date shall not be extended after 2029 (Section 2(a)(2)(A)(ii)).
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Increased requirements for managed care organizations: Medicaid managed care organizations, prepaid inpatient health plans, and prepaid ambulatory health plans must either engage in their own review period or permit a State-engaged contractor to conduct reviews (Section 3).
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Retrospective audit limitations: Contracts with recovery audit contractors must provide that audit and recovery activities are conducted for a period of 4 fiscal years prior to the current fiscal year (Section 4(c)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Economy And Finance
- Reduces Government Spending+5
- Healthcare
- Increases Medicaid Funding+3
- Demographic And Interest Groups
- Good For Low Income Households+2
- Social Issues And Justice
- Improves Poverty Reduction+1
- 6/24/2026
- Read twice and referred to the Committee on Finance.
- Introduced in Senate
One bill Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.