# 119-hr-9422: Medicaid RAC Improvement Act of 2026

119-hr-9422, Medicaid RAC Improvement Act of 2026, is a 119th Congress bill sponsored by Rep. Bilirakis, Gus M. [R-FL-12] (R-FL); status introduced; PRIA reads it as touching household money (as of 2026-10-04).

- Canonical: https://policyrisk.com/legislation/119-hr-9422
- As of: 2026-10-04
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-9422
- Congress: 119
- Title: Medicaid RAC Improvement Act of 2026
- Status: introduced
- Introduced: 2026-06-24
- Sponsor: Rep. Bilirakis, Gus M. [R-FL-12] (R-FL)
- Cosponsors: 9
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-10-04

## Summary

**Strengthen oversight of the Medicaid Recovery Audit Contractor program and bring Medicaid managed care into its audits.** The bill would tighten CMS monitoring, require more state reporting, and set specific time limits and review windows for audit and recovery activities. - States: States would face new notification and reporting rules, including CMS notices of RAC exception State Plan Amendment expirations and annual state reports on how their RAC programs operate. The bill also prevents extension of certain RAC exception approvals after 2029 and requires detailed methodologies for audit limits or exclusions. - Medicaid managed care plans and contractors: The bill would require claims paid by Medicaid managed care organizations and prepaid plans to be subject to RAC reviews and would force contracts to include either a designated payment-integrity review period of up to 18 months after payment or permission for RAC contractors to review claims. Contracts and RAC agreements must coordinate recovery activities. - Federal transparency and participation: The Secretary must set policies within 180 days, Congress would get annual state-by-state reports starting in 2027, and a study on barriers to state RAC participation must be delivered within 1 year. The bill also sets a 4 fiscal year retrospective recovery window for audits.

## Cosponsors (9)

- Rep. Arrington, Jodey C. [R-TX-19] (R-TX), 2026-06-24T00:00:00.000Z
- Rep. Cammack, Kat [R-FL-3] (R-FL), 2026-06-24T00:00:00.000Z
- Rep. Carter, Earl L. "Buddy" [R-GA-1] (R-GA), 2026-06-24T00:00:00.000Z
- Rep. Miller-Meeks, Mariannette [R-IA-1] (R-IA), 2026-06-24T00:00:00.000Z
- Rep. Palmer, Gary J. [R-AL-6] (R-AL), 2026-06-24T00:00:00.000Z
- Rep. Bean, Aaron [R-FL-4] (R-FL), 2026-06-24T00:00:00.000Z
- Rep. Allen, Rick W. [R-GA-12] (R-GA), 2026-06-24T00:00:00.000Z
- Rep. Smucker, Lloyd [R-PA-11] (R-PA), 2026-07-06T00:00:00.000Z
- Rep. Pfluger, August [R-TX-11] (R-TX), 2026-07-30T00:00:00.000Z

## Provisions PRIA read

- Study and demonstration to expand state Medicaid audits: benefit, medium. If enacted, the Secretary would study why States face barriers to starting Medicaid recovery audit programs and report to Congress within 1 year. Based on that study, the Secretary would run a 5-year demonstration to increase State RAC adoption. The Secretary would start the demonstration within tw…
- New managed-care audit rules: mixed, medium. If enacted, State Medicaid RAC programs would have to include reviews of claims paid by Medicaid managed care plans and prepaid plans. States would need to assure, by January 1, 2028, that managed-care contracts either allow the plan an elected review period or let a State RAC contractor review cla…
- Stronger Medicaid RAC oversight and audits: mixed, medium. If enacted, the Secretary would send annual reports to Congress about Medicaid RAC effectiveness starting by December 31, 2027, with state-by-state detail on recoveries, underpayments, appeals, and top initiatives. Each State would also have to send a standard report, within one year and annually a…

## Related bills

- 119-hr-1: One Big Beautiful Bill Act
- 119-hr-21: Born-Alive Abortion Survivors Protection Act
- 119-hr-1301: Death Tax Repeal Act
- 119-hr-703: Main Street Tax Certainty Act
- 119-hr-425: Repealing Big Brother Overreach Act
- 119-hr-38: Constitutional Concealed Carry Reciprocity Act of 2025

## Sources
- [119-hr-9422 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/9422)

## Related
- [119-hr-1: One Big Beautiful Bill Act](https://policyrisk.com/legislation/119-hr-1)
- [119-hr-21: Born-Alive Abortion Survivors Protection Act](https://policyrisk.com/legislation/119-hr-21)
- [119-hr-1301: Death Tax Repeal Act](https://policyrisk.com/legislation/119-hr-1301)
- [119-hr-703: Main Street Tax Certainty Act](https://policyrisk.com/legislation/119-hr-703)
- [119-hr-425: Repealing Big Brother Overreach Act](https://policyrisk.com/legislation/119-hr-425)
- [119-hr-38: Constitutional Concealed Carry Reciprocity Act of 2025](https://policyrisk.com/legislation/119-hr-38)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-9422 (as of 2026-10-04).