# 119-hr-10615: Medicaid Integrity Improvement Act

119-hr-10615, Medicaid Integrity Improvement Act, is a 119th Congress bill sponsored by Rep. Balderson, Troy [R-OH-12] (R-OH); status introduced; PRIA reads it as touching household money (as of 2026-10-10).

- Canonical: https://policyrisk.com/legislation/119-hr-10615
- As of: 2026-10-10
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-10615
- Congress: 119
- Title: Medicaid Integrity Improvement Act
- Status: introduced
- Introduced: 2026-09-28
- Sponsor: Rep. Balderson, Troy [R-OH-12] (R-OH)
- Cosponsors: 3
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-10-10

## Summary

**This bill would require annual, risk-based audits of high-risk Medicaid providers and suppliers** to detect potential fraud, waste, and abuse and to report audit results as part of state Medicaid fraud-control programs. It ties those audits to statewide programs and coordination with the HHS Office of Inspector General and state Medicaid agencies. - State Medicaid Fraud Control Units would have to audit a statistically valid sample of high-risk providers at least annually, beginning not later than 1 year after enactment, and include audit summaries and overpayment findings in their annual reports. - Providers and suppliers designated as high-risk would face targeted reviews based on factors like abnormal billing, prior audits, payment anomalies, ownership changes, or credible fraud allegations, and audits could lead to identified overpayments and referrals for collection. - The HHS Secretary could still certify a unit that misses the audit requirement if the unit submits and implements a corrective action plan that meets the Secretary's standards.

## Cosponsors (3)

- Rep. Bilirakis, Gus M. [R-FL-12] (R-FL), 2026-09-28T00:00:00.000Z
- Rep. Joyce, John [R-PA-13] (R-PA), 2026-09-28T00:00:00.000Z
- Rep. Pfluger, August [R-TX-11] (R-TX), 2026-09-28T00:00:00.000Z

## Provisions PRIA read

- Annual audits of high-risk Medicaid providers: mixed, high. This bill would require the State entity that runs the statewide Medicaid integrity program to audit a statistically valid sample of high-risk Medicaid providers and suppliers. Audits would start no later than 1 year after enactment and must happen at least once each year. Audits would be done in c…

## Related bills

- 119-hr-4669: FEMA Act of 2025
- 119-hr-1262: Mikaela Naylon Give Kids a Chance Act
- 119-hr-21: Born-Alive Abortion Survivors Protection Act
- 119-hr-1227: Alternatives to PAIN Act
- 119-hr-987: Fair Access to Banking Act
- 119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act

## Sources
- [119-hr-10615 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/10615)

## Related
- [119-hr-4669: FEMA Act of 2025](https://policyrisk.com/legislation/119-hr-4669)
- [119-hr-1262: Mikaela Naylon Give Kids a Chance Act](https://policyrisk.com/legislation/119-hr-1262)
- [119-hr-21: Born-Alive Abortion Survivors Protection Act](https://policyrisk.com/legislation/119-hr-21)
- [119-hr-1227: Alternatives to PAIN Act](https://policyrisk.com/legislation/119-hr-1227)
- [119-hr-987: Fair Access to Banking Act](https://policyrisk.com/legislation/119-hr-987)
- [119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage A…](https://policyrisk.com/legislation/119-hr-842)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-10615 (as of 2026-10-10).