# 119-s-4898: Medicaid RAC Improvement Act of 2026

119-s-4898, Medicaid RAC Improvement Act of 2026, is a 119th Congress bill sponsored by Sen. Scott, Rick [R-FL] (R-FL); status introduced; PRIA reads it as touching household money (as of 2026-10-10).

- Canonical: https://policyrisk.com/legislation/119-s-4898
- As of: 2026-10-10
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-s-4898
- Congress: 119
- Title: Medicaid RAC Improvement Act of 2026
- Status: introduced
- Introduced: 2026-06-24
- Sponsor: Sen. Scott, Rick [R-FL] (R-FL)
- Cosponsors: 0
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-10-10

## Summary

**Improve Medicaid payment integrity** by strengthening how States audit and recover Medicaid overpayments and by expanding those audits into managed care. - States would file annual, detailed reports on their Medicaid Recovery Audit Contractor programs, explain the methodologies behind audit limits or exclusions, and face a statutory cut-off for some RAC exception approvals through 2028. RAC contracts would limit audits to the current fiscal year and up to four prior fiscal years. - Medicaid managed care plans and prepaid health plans would be included in RAC reviews and would either agree to a payment integrity review period up to 18 months after a claim or allow a State RAC contractor to conduct the review. States must put these contract assurances in place by January 1, 2028. - The bill would boost transparency and oversight. It directs the Secretary to deliver an initial report to Congress by December 31, 2027 and annual updates, orders a study on barriers to State participation including contingency fee structures and startup costs, and creates a five-year demonstration to increase State participation in RAC programs.

## Provisions PRIA read

- New annual Medicaid audit reports: benefit, high. If enacted, the Secretary would send Congress an annual report on the Medicaid RAC program. The first report would be due not later than December 31, 2027 and annually thereafter. The reports would include State‑level totals for overpayments recovered and underpayments, pre‑payment savings, appeals…
- Study and demo to expand RACs: benefit, medium. If enacted, the Secretary would study barriers to State RAC programs and report to Congress within 1 year. The study would examine contingency fees, multi‑State contracts, and start‑up costs. Based on that study, the Secretary would start a 5‑year demonstration within 2 years to increase State RAC…
- Limit and monitor RAC exceptions: mixed, high. If enacted, the bill would stop authorizing RAC exceptions after December 31, 2028. The Secretary would issue rules within 180 days to notify States with approved exception SPAs about their expiration dates and say approvals will not be extended after 2029. States with approved RAC exception SPAs w…
- More Medicaid managed-care audits: mixed, high. If enacted, the bill would explicitly let RAC reviews include Medicaid managed care and prepaid plans. States would have to assure by January 1, 2028 that contracts let plans elect a payment‑integrity review (no longer than the lesser of 18 months after payment or the contract term) or let a State…

## Related bills

- 119-s-2120: Older Americans Act Reauthorization Act of 2025
- 119-s-1541: SHIPS for America Act of 2025
- 119-s-1748: Kids Online Safety Act
- 119-s-4782: ReportScams.gov Act
- 119-s-4280: SAFE Act
- 119-s-690: Overdose RADAR Act

## Sources
- [119-s-4898 on Congress.gov](https://www.congress.gov/bill/119th-congress/senate-bill/4898)

## Related
- [119-s-2120: Older Americans Act Reauthorization Act of 2025](https://policyrisk.com/legislation/119-s-2120)
- [119-s-1541: SHIPS for America Act of 2025](https://policyrisk.com/legislation/119-s-1541)
- [119-s-1748: Kids Online Safety Act](https://policyrisk.com/legislation/119-s-1748)
- [119-s-4782: ReportScams.gov Act](https://policyrisk.com/legislation/119-s-4782)
- [119-s-4280: SAFE Act](https://policyrisk.com/legislation/119-s-4280)
- [119-s-690: Overdose RADAR Act](https://policyrisk.com/legislation/119-s-690)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-s-4898 (as of 2026-10-10).