This bill aims to strengthen efforts against Medicaid fraud by expanding the responsibilities of State Medicaid fraud control units. Currently, these units primarily focus on fraud committed by healthcare providers. The legislation seeks to broaden their mandate to include investigating and prosecuting instances of fraud perpetrated by individuals who apply for or receive Medicaid services. Specifically, the bill amends Section 1903(q)(3) and Section 1902(a)(61) of the Social Security Act. These amendments clarify that fraud control units must address fraud related to the application for , or receipt of , Medicaid services, ensuring beneficiary fraud falls within their investigative and prosecutorial scope, with the changes becoming effective 180 days post-enactment.
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Timeline
Introduced in House
Referred to the House Committee on Energy and Commerce.
Introduced in House
Referred to the House Committee on Energy and Commerce.
Health
STOP FRAUD in Medicaid Act
USA119th CongressHR-5364| House
| Updated: 9/15/2025
This bill aims to strengthen efforts against Medicaid fraud by expanding the responsibilities of State Medicaid fraud control units. Currently, these units primarily focus on fraud committed by healthcare providers. The legislation seeks to broaden their mandate to include investigating and prosecuting instances of fraud perpetrated by individuals who apply for or receive Medicaid services. Specifically, the bill amends Section 1903(q)(3) and Section 1902(a)(61) of the Social Security Act. These amendments clarify that fraud control units must address fraud related to the application for , or receipt of , Medicaid services, ensuring beneficiary fraud falls within their investigative and prosecutorial scope, with the changes becoming effective 180 days post-enactment.