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HR 9422

Medicaid RAC Improvement Act of 2026

119th Congress Introduced by Rick Allen and 8 co-sponsors

HR 9422 aims to enhance Medicaid integrity by reforming the Medicaid Recovery Audit Contractor program to increase overpayment recoveries and expand detection of waste and fraud.

Introduced in House
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WeVote Research Nonpartisan
Bill Summary · HR 9422

Summary of HR 9422 (Session 119)

Purpose and intent

HR 9422 aims to implement recommendations from the Comptroller General of the United States focused on improving the Medicaid Recovery Audit Contractor (RAC) program and identifying additional methods to recover Medicaid overpayments. The bill also carries provisions “for other purposes,” signaling potential ancillary reforms related to Medicaid audit and recovery processes. The overarching goal is to enhance federal and state Medicaid program integrity by increasing and optimizing overpayment recovery.

Key provisions and changes

  • Medicaid RAC program enhancements: The bill directs or authorizes changes to how the Medicaid Recovery Audit Contractor program operates. While the exact statutory text is not provided here, typical components of such reforms may include:
    • Increased oversight and transparency of RAC activities.
    • Revisions to audit methodologies to improve accuracy and reduce improper payments.
    • Changes to payment structures or performance metrics for RACs.
    • Expanded training, standards, or qualifications for RAC contractors.
  • Identification of additional recovery opportunities: The bill seeks to broaden avenues for detecting and recouping Medicaid overpayments. This could involve:
    • New data-sharing or analytics requirements among agencies and states.
    • Expanded review of claims, payments, and eligibility determinations.
    • Additional waste, fraud, and abuse (WFA) detection measures beyond traditional RAC activities.
  • Compliance and oversight enhancements: Provisions may establish or strengthen reporting requirements, audits of RAC entities, and enforcement mechanisms to ensure contractors adhere to program integrity standards.
  • Other related Medicaid integrity measures: The “for other purposes” clause suggests potential ancillary provisions such as pilot programs, funding authorizations, or targeted reforms affecting Medicaid administration and auditing.

who would be affected

  • Medicaid agencies (federal and state): Responsible for implementing RAC activities and applying enhanced audit guidance.
  • Medicaid RAC contractors: Would be subject to revised performance criteria, contract terms, and oversight requirements.
  • Medicaid beneficiaries and providers: Beneficiaries could benefit from more accurate payments and reduced improper expenditures; providers may see adjusted audit practices and potential impacts on billing and recoupment processes.
  • Center for Medicare & Medicaid Services (CMS) and related offices: Likely to oversee and enforce new RAC-related standards and reporting.

Procedural and timeline aspects

  • Introduction and referral: The bill was introduced in the House and referred to the House Committee on Energy and Commerce on June 24, 2026.
  • Potential committee actions: The committee may hold hearings, amend, and report the bill to the full House. If reported, floor consideration would follow, potentially with additional amendments.
  • Implementation timeline: Specific effective dates, phase-in periods, and funding authorizations would be defined in the bill’s text. Given standard practice, implementations could be phased over multiple fiscal years with interim benchmarks.

Additional considerations

  • The bill lists several co-sponsors, indicating bipartisan backing and wide congressional interest in Medicaid integrity and RAC reform.
  • Details such as funding levels, exact statutory changes to RAC contracts, data-sharing requirements, and penalties for noncompliance would be specified in the formal bill text and any accompanying committee reports.

If you’d like, I can tailor this summary to emphasize particular stakeholders (states, providers, or beneficiaries) or compare it to prior Medicaid RAC reform efforts for context.

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

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