S. 5609: HCBS Anti-Fraud Reporting Act of 2026

This bill would require states to give the federal government yearly reports about fraud prevention in certain Medicaid home and community-based services programs.

What the bill changes

The bill amends Medicaid law for 1915(c) waivers, which are programs that let states use Medicaid funds to provide long-term care and support services in a person’s home or community instead of in an institution.

Starting with 2026 and each year after, a state would have to report to the Secretary of Health and Human Services on:

• Any waste, fraud, or abuse the state found in services provided under the waiver program
• What the state is doing to prevent waste, fraud, and abuse

What this means in practice

The bill does not create a new benefit program or change who can receive services. Instead, it adds a reporting requirement. States would need to track and share information about problems they find in these Medicaid waiver services, along with the steps they are taking to reduce those problems.

The goal appears to be to give the federal government more information about fraud risks and state anti-fraud efforts in home and community-based care programs.

Relevant Companies

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