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Bill

S 4898

A bill to implement recommendations of the Comptroller General of the United States for improving the Medicaid Recovery Audit Contractor program and identifying additional opportunities to recover Medicaid overpayments, and for other purposes.

119th Congress Introduced by Rick Scott

Strengthen the Medicaid RAC program and broaden recovery of improper Medicaid payments by implementing GAO recommendations and expanding overpayment recapture.

Introduced in Senate
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WeVote Research Nonpartisan
Bill Summary · S 4898

Overview

Bill S. 4898, introduced in the 119th Congress and referred to the Senate Committee on Finance, seeks to implement recommendations from the Comptroller General of the United States aimed at improving the Medicaid Recovery Audit Contractor (RAC) program and identifying additional opportunities to recover Medicaid overpayments. The sponsor is a co-sponsor from Florida, Senator Rick Scott.

Purpose and intent

  • To adopt and operationalize recommendations from the Comptroller General to strengthen the Medicaid RAC program.
  • To expand efforts to identify and recover Medicaid overpayments.
  • To improve program integrity, recapture improper Medicaid expenditures, and reduce improper payments within the Medicaid program.

Key provisions and changes (as described by the bill’s title and purpose)

  • Implement GAO recommendations: The bill directs or authorizes actions designed to align the Medicaid RAC program with GAO-recommended practices. This likely includes governance, oversight, data analytics, performance measures, and contracting reforms.
  • Strengthen RAC program operations: Measures to enhance how Recovery Audit Contractors identify, review, and recoup Medicaid overpayments, including processes for audits, timelines, documentation, and appeal rights.
  • Expand overpayment recovery: Provisions intended to broaden the scope or effectiveness of identifying and recovering improper Medicaid expenditures from providers, managed care plans, or other entities involved in Medicaid financing.
  • Other related purposes: Additional statutory changes to support program integrity, auditing efficiency, data sharing, or enforcement mechanisms within Medicaid, as needed to implement the recommendations.

Note: The summary reflects the bill’s stated aim to implement GAO recommendations and to identify further overpayment recovery opportunities; the exact technical, procedural, and funding details would be specified in the text of the statute.

Who would be affected

  • Medicaid providers: Hospitals, physicians, nursing facilities, and other health care providers participating in Medicaid who could face more robust audit activities and potential recoupment of overpayments.
  • State Medicaid programs: States administering Medicaid programs would implement streamlined RAC processes and related integrity measures, potentially affecting state workloads, intergovernmental coordination, and funding.
  • Recovery Audit Contractors (RACs): Private entities contracted to conduct recoveries would operate under updated guidelines, performance criteria, and reporting requirements.
  • Beneficiaries: Indirectly affected through potential reduction in improper payments, which could influence program integrity and sustainability.

Procedural and timeline aspects

  • Introduction and referral: The bill was introduced in the Senate and referred to the Committee on Finance on June 24, 2026.
  • Next steps: Committee consideration, potential markups, and floor action would follow if the committee reports the bill. Any amendments would be incorporated before final passage and potential conference with the House.

Potential impacts and considerations

  • Financial impact: While specific funding and cost implications are not detailed here, the bill’s aim is to increase recovery of improper Medicaid payments, potentially saving federal and state dollars over time.
  • Compliance burden: Providers and state agencies may face enhanced audit requirements, training, and reporting standards.
  • Transparency and accountability: The focus on GAO recommendations suggests emphasis on measurable performance, oversight, and clearer procedures for audits and appeals.

If you’d like, I can pull the full text to extract precise provisions, section numbers, and any funding authorizations or reporting requirements for a more granular summary.

Compiled from official sources — confirm details with the bill’s official record.

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