H.R. 9422 · Where this bill is now
In committee
Introduced in the House, sent to the Committee on Energy and Commerce, Jun 24, 2026
What this bill does
In plain words · AI-written from the official summaryMedicaid Recovery Audit Contractor requirements expand
Recovery Audit Contractors, or RACs, are hired to find overpaid or underpaid Medicaid claims and correct them. This bill requires all state Medicaid programs to use RACs starting in 2029, ending the ability for states to skip this step. It also expands what RACs can review—including payments to managed care health plans—and lets them look back four years instead of less time. The bill also requires more reporting on how well RACs are working.
How it affects you
This mainly affects state Medicaid programs and healthcare providers that bill Medicaid. States that currently have exceptions from using RACs will need to start using them by 2029, which could mean more audits of their Medicaid payments. Managed care organizations and health plans that work with Medicaid may face more reviews of their payments. For people on Medicaid, this could mean better oversight of the program, though the bill doesn't directly spell out how that changes their benefits or care.
Read the official summary (Introduced in House, Jun 24, 2026)
Medicaid RAC Improvement Act of 2026
This bill establishes additional requirements for and expands the scope of Medicaid Recovery Audit Contractors (RACs). RACs identify improper Medicaid payments to providers, collect overpayments, and reimburse underpayments.
Current law requires state Medicaid programs to establish a RAC program; however, states may apply to the Centers for Medicare & Medicaid Services (CMS) for an exception. The bill prohibits the CMS from granting exceptions after December 31, 2028. The CMS must inform states that have an approved RAC exception that the exception will not be renewed after this date, and it must also inform these states of the current expiration date of their excepted status.
The bill also expands the scope of RACs to include a review of payments to Medicaid managed care organizations, prepaid inpatient health plans, and prepaid ambulatory health plans. In addition, the bill expands the period of review for RACs to include the four-year period prior to the fiscal year at issue.
Finally, the bill establishes reporting requirements relating to the effectiveness of RACs, including annual reports with state-specific data on collected overpayments. The CMS must also conduct a study and establish a related demonstration program to increase the number of states with a RAC program.
Written by AI (Claude) using only the official summary by the Congressional Research Service, the Library of Congress’s nonpartisan research staff. It can miss nuance, so check the official summary and the bill text for details.
2nd SessionH. R. 9422
A BILL
Medicaid RAC Improvement Act of 2026
Sponsor: Rep. Gus M. Bilirakis (R-FL-12) · Introduced Jun 24, 2026 · Health · 1 version of the text
Sources: Congress.gov actions and votes · bill text from GovInfo · latest official action Jun 24, 2026: “Referred to the House Committee on Energy and Commerce.”