Requiring single fiscal agents under Medicaid

Section 1902 of the Social Security Act (42 U.S.C. 1396a) is amended— (1) in subsection (a)— (A) in paragraph (89), by striking and at the end; (B) in paragraph (90), by striking the period at the end and inserting; and; and (C) by inserting after paragraph (90) the following new paragraph: (91) provide that, beginning January 1, 2028, the State shall designate an individual as the individual primarily responsible for ensuring, through the establishment of appropriate policies, procedures, monitoring systems, and corrective actions, the following with respect to the State plan (or waiver of such plan): (A) The processing and adjudication of claims in an accurate and timely manner. (B) Payment integrity, including by— (i) identifying and preventing fraud, waste, abuse, and improper payments; (ii) overseeing program integrity activities; and (iii) in the case that deficiencies are identified, implementing corrective actions. (C) Appropriate financial reporting, including by ensuring the accuracy, completeness, and timeliness of— (i) reporting of State expenditures under such plan or waiver; (ii) reporting of such expenditures that are eligible for Federal financial participation; and (iii) any other financial information submitted to the Secretary. (D) The establishment and maintenance of controls to ensure that expenditures under such plan or waiver comply with all applicable Federal requirements..