H.R. 5364: States Taking On Power For Redressing All Unlawful Deceits in Medicaid Act

This bill, titled the **States Taking On Power For Redressing All Unlawful Deceits in Medicaid Act** or **STOP FRAUD in Medicaid Act**, aims to enhance the ability of state Medicaid fraud control units to investigate and prosecute fraud committed by individuals receiving Medicaid benefits.

Key Provisions

• This legislation modifies the existing rules in the Social Security Act regarding Medicaid fraud. The changes focus on ensuring that not only the providers of Medicaid services but also the **beneficiaries** (individuals applying for and receiving Medicaid) can be investigated for fraud.
• The bill amends Section 1903(q)(3) of the Social Security Act to include language that specifies the application for or receipt of services by individuals as part of potential fraudulent activity.
• Additionally, it updates Section 1902(a)(61) of the Social Security Act to reflect similar language changes about the provisions relevant to beneficiaries.
• These changes are designed to clarify that fraudulent acts are not limited to service providers but also extend to individuals who might be committing fraud in the application for or receipt of Medicaid services.
• The effective date for these amendments will be 180 days after the enactment of the Act, meaning states will have a set period to prepare for the new rules once the bill is signed into law.

Impacts

The intention behind the bill is to strengthen the fight against Medicaid fraud by giving states the authority to pursue fraudulent claims made by beneficiaries. This could potentially lead to an increase in the number of investigations and prosecutions targeting individuals who unlawfully obtain services or benefits from Medicaid.

Relevant Companies

• None found