State units would investigate individuals for Medicaid application and benefit fraud.
This bill would make state Medicaid fraud control units investigate individuals who commit fraud when applying for or receiving Medicaid benefits. Currently, these units mainly focus on fraud by healthcare providers. This change means people who try to cheat the Medicaid system could face more investigations.
Currently, state Medicaid fraud control units mainly investigate fraud committed by healthcare providers. State Medicaid plans also focus on fraud related to the services provided. If this bill passes, these units would also be explicitly directed to investigate individuals who commit fraud when applying for or receiving Medicaid. State plans would also need to reflect this broader scope.
HR 5364 · 119th Congress · September 15, 2025 · AI Summary by gemini-2.5-flash · 10/10
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