Medicaid Integrity and Fiscal Accountability Act
Sponsored By: Representative Pfluger, August [R-TX-11]
Introduced
Summary
Centralizes State Medicaid fiscal responsibility in a single designated official. This bill would require each State to designate one person by January 1, 2028 to be primarily responsible for fiscal administration of the State Medicaid plan and any waivers.
Show full summary
- States and Medicaid agencies: Would have to name a single fiscal lead by January 1, 2028 and create policies, monitoring systems, and corrective actions to ensure accurate and timely claims processing, payment integrity, financial reporting, and internal controls.
- Medicaid beneficiaries and providers: Would require systems to ensure claims are processed accurately and timely and to prevent fraud, waste, abuse, and improper payments, which could affect payment reliability and claim adjudication.
- Federal oversight and reporting: Would standardize the duties and financial information States must provide to the Secretary and align State fiscal governance with federal program integrity expectations.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 1 benefits, 0 costs, 0 mixed.
One Medicaid fiscal officer per State
This bill would require each State to name one main Medicaid fiscal officer by January 1, 2028. That person would have to set up policies, monitoring, and corrective actions to keep claims processing accurate and timely. They would lead payment-integrity work to find and stop fraud, waste, abuse, and improper payments. They would also be responsible for accurate, complete, and timely financial reporting and for controls that make sure Medicaid spending follows federal rules.
Sponsors & CoSponsors
Sponsor
Pfluger, August [R-TX-11]
TX • R
Cosponsors
Rep. Joyce, John [R-PA-13]
PA • R
Sponsored 9/28/2026
Rep. Balderson, Troy [R-OH-12]
OH • R
Sponsored 9/28/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov