# 119-hr-10625: Medicaid Integrity Improvement Act

119-hr-10625, Medicaid Integrity Improvement Act, is a 119th Congress bill sponsored by Rep. Joyce, John [R-PA-13] (R-PA); status introduced; PRIA reads it as touching household money (as of 2026-10-11).

- Canonical: https://policyrisk.com/legislation/119-hr-10625
- As of: 2026-10-11
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-10625
- Congress: 119
- Title: Medicaid Integrity Improvement Act
- Status: introduced
- Introduced: 2026-09-28
- Sponsor: Rep. Joyce, John [R-PA-13] (R-PA)
- Cosponsors: 5
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-10-11

## Summary

**This bill would require State Medicaid Fraud Control Units to perform annual audits of high‑risk Medicaid providers and suppliers** to spot potential fraud, waste, and abuse. It also would require regular reporting on audit findings and overpayments and allow the HHS Secretary to enforce corrective action when audits or reporting fall short. - State Medicaid Fraud Control Units (MFCUs) would have to audit a statistically valid sample of high‑risk providers at least annually, coordinating with the HHS Inspector General and the State Medicaid agency as appropriate. Reports must summarize audits and show the extent to which overpayments were identified and collected or referred. - The HHS Secretary could still certify or recertify an entity that missed the audit requirement if the entity submits and implements a corrective action plan that meets the Secretary's standards. This creates a formal enforcement and remediation route. - "High‑risk" providers and suppliers are defined to include those flagged under the federal screening process or identified by risk factors like abnormal billing, prior audits, ownership changes, affiliations with sanctioned entities, or credible fraud allegations. Those providers would face structured, reportable scrutiny and potential recoupment when improper payments are found.

## Cosponsors (5)

- Rep. Bilirakis, Gus M. [R-FL-12] (R-FL), 2026-09-28T00:00:00.000Z
- Rep. Pfluger, August [R-TX-11] (R-TX), 2026-09-28T00:00:00.000Z
- Rep. Kennedy, Mike [R-UT-3] (R-UT), 2026-09-28T00:00:00.000Z
- Rep. Carter, Earl L. "Buddy" [R-GA-1] (R-GA), 2026-09-28T00:00:00.000Z
- Rep. Balderson, Troy [R-OH-12] (R-OH), 2026-09-28T00:00:00.000Z

## Provisions PRIA read

- Annual audits of high-risk Medicaid providers: benefit, high. This bill would require the statewide entity that runs the Medicaid fraud control 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 would happen at least once a year. Audits must be done in coordi…

## Related bills

- 119-hr-1262: Mikaela Naylon Give Kids a Chance Act
- 119-hr-1227: Alternatives to PAIN Act
- 119-hr-4299: Protecting Patient Access to Cancer and Complex Therapies Act
- 119-hr-7: No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2025
- 119-hr-3514: Improving Seniors’ Timely Access to Care Act of 2025
- 119-hr-879: Medicare Patient Access and Practice Stabilization Act of 2025

## Sources
- [119-hr-10625 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/10625)

## Related
- [119-hr-1262: Mikaela Naylon Give Kids a Chance Act](https://policyrisk.com/legislation/119-hr-1262)
- [119-hr-1227: Alternatives to PAIN Act](https://policyrisk.com/legislation/119-hr-1227)
- [119-hr-4299: Protecting Patient Access to Cancer and Complex Therapies Act](https://policyrisk.com/legislation/119-hr-4299)
- [119-hr-7: No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of…](https://policyrisk.com/legislation/119-hr-7)
- [119-hr-3514: Improving Seniors’ Timely Access to Care Act of 2025](https://policyrisk.com/legislation/119-hr-3514)
- [119-hr-879: Medicare Patient Access and Practice Stabilization Act of 2025](https://policyrisk.com/legislation/119-hr-879)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-10625 (as of 2026-10-11).