Medicare Payment Integrity Enhancement Act of 2026

Sponsor: Lloyd Smucker (Republican-PA)May 13, 2026

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Introduced

In Committee

Passed One Chamber

Passed Both Chambers

Signed into Law

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.

Medicare claims would be checked for errors before payments are sent out.

This bill would let the government hire contractors to review healthcare bills before Medicare pays them, aiming to stop incorrect payments upfront. This could affect how quickly healthcare providers get paid and how Medicare beneficiaries' claims are handled. New rules for these reviews would be set within about a year.

What Would Change

Currently, contractors mainly find and get back improper Medicare payments after they've already been made. This bill would let the government hire contractors to review Medicare claims before payments are sent out, aiming to stop incorrect payments from happening at all. New rules and contracts for these prepayment reviews would be put in place within about one year of the bill becoming law.

Key Provisions

Lets the government hire contractors to check Medicare claims for errors before payments are made.
Sets up a new way to pay these contractors based on how many incorrect payments they stop, encouraging quick and fair reviews.
Moves money from Medicare's main funding accounts to pay for these new prepayment reviews.
Requires the Secretary of Health and Human Services to create new rules within one year to carry out these changes, including how contractors are paid and how savings are counted.
Requires new contracts for prepayment reviews to be in place within one year of the bill becoming law.

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HR 8804 · 119th Congress · May 13, 2026 · AI Summary by gemini-2.5-flash · 8/10

Medicare Payment Integrity Enhancement Act of 2026

What Would Change

Key Provisions

Lobbying Activity