H.R. 10618: Strengthening Tools for Oversight to Prevent Medicaid Fraud Act of 2026

This bill would require state Medicaid programs to use an electronic verification system to confirm certain services were actually provided, starting on January 1, 2027.

What services are covered

The new requirement would apply to two types of Medicaid-covered services:

• Non-emergency transportation services — rides provided to Medicaid recipients for medical appointments or other covered care when it is not an emergency.
• Applied behavior analysis (ABA) services — behavioral therapy services, often used for people with autism and related conditions.

What states would have to do

States would have to make sure these services are electronically verified when they are delivered. The bill says the verification system must track the service in a way similar to the existing Medicaid rules for electronic visit verification, which are already used for some other home- and personal-care services.

How enforcement would work

If the federal government finds that a state is not following the rule, the Secretary of Health and Human Services would have to notify the state. The state would then have to submit a corrective action plan within 90 days, explaining how it will come into compliance within one year of receiving the notice.

States already using a system

The bill would not apply to states that already require some kind of electronic verification system for these services when the law takes effect, as long as they continue using that system.

What the bill means in practice

In practical terms, the bill is designed to make it easier for states to document that these Medicaid services were really provided, which may help reduce billing errors or fraud. It would also create a new compliance requirement for states that do not already have such systems in place.

Relevant Companies

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