Human services: medical services; reporting of error rate regarding Medicaid; require. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 106c.

2025-2026 Regular Session Introduced by Joe Aragona and 6 co-sponsors

HB 5813 requires the Michigan DHHS to annually publish Medicaid error and improper payment rates on its site and to legislative committees.

REFERRED TO COMMITTEE ON HOUSING AND HUMAN SERVICES

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Purpose

HB 5813 proposes to add a new section (Sec. 106c) to the Social Welfare Act (1939 PA 280) to require the Michigan Department of Health and Human Services (the department) to publicly report metrics related to Medicaid payments. Specifically, the bill aims to increase transparency around improper Medicaid payments by annually disclosing error and improper payment rates starting October 1, 2026.

Key Provisions

Annual reporting obligation (Sec. 106c(1))
Beginning October 1, 2026, the department must:

Annually report the Medicaid error rate and the Medicaid improper payment rate.
Post the reports on the department’s website.
Provide the reports to the standing committees of the Michigan House of Representatives and Senate that oversee government operations.

Definitions (Sec. 106c(2))

Error rate: Defined as erroneous excess payments for medical assistance as described in 42 U.S.C. § 1396b(u)(1)(D). This aligns with federal definitions used to identify improper Medicaid payments due to errors.
Improper payment: Defined according to 31 U.S.C. § 3351, which generally includes any payment that should not have been made or was made in an incorrect amount or to an ineligible recipient.

Who/What Is Affected

Primary entity: Michigan Department of Health and Human Services (the department), which administers Medicaid in Michigan.

Recipients and providers: While not directly altering eligibility or payment rules, the bill increases transparency about improper payments and error rates, potentially informing policymakers, stakeholders, and the public.

Legislative oversight: The annual reports are to be shared with the standing committees of the state House and Senate responsible for oversight of government operations.

Procedural and Timeline Details

Effective date for reporting: October 1, 2026 (first required annual report and posting).

Reporting channel: Reports must be posted on the department’s website and provided to the relevant legislative oversight committees.

Status and sponsorship:

Introduced: April 16, 2026
Referred to Committee: Government Operations
Primary sponsors include Rep. Jason Woolford, with a cohort of co-sponsors: Luke Meerman, Matt Bierlein, Tim Kelly, Mike Harris, Jennifer Wortz, and Joe Aragona.

Practical Implications

Public transparency: The bill makes Medicaid payment accuracy data publicly accessible, potentially informing state accountability efforts, performance improvement initiatives, and public discourse around program integrity.

Compliance burden: The department would need to collect, validate, and publish standardized metrics annually, ensuring consistency with federal definitions of error and improper payments.

Policy use: Data could guide targeted interventions to reduce improper payments, align with federal audits, and benchmark against other states.

If enacted, HB 5813 would codify a regular, public-facing reporting requirement for Medicaid payment accuracy, reinforcing accountability without altering existing statutory payment rules or procedures.

Bill