Dr. Miller-Meeks Introduces Legislation to Strengthen Medicaid Accountability and Protect Taxpayer Dollars

WASHINGTON, D.C. — Congresswoman Mariannette Miller-Meeks, M.D. (IA-01), joined Congressman Gus Bilirakis (FL-12), House Budget Committee Chairman Jodey Arrington (TX-19), and Congresswoman Kat Cammack (FL-03) in introducing the Medicaid RAC Improvement Act of 2026, bipartisan legislation to strengthen Medicaid oversight, improve accountability, and better protect taxpayer dollars from waste, fraud, and abuse.

Medicaid provides critical health care coverage to millions of Americans, including children, seniors, individuals with disabilities, and low-income families. However, longstanding oversight deficiencies identified by the Government Accountability Office (GAO) have left significant gaps in payment integrity efforts, weakening accountability and making it more difficult to identify improper payments.

“As a physician, I’ve seen firsthand how important Medicaid is for our most vulnerable patients. But every dollar lost to waste, fraud, and abuse is a dollar that isn’t reaching the people the program was designed to serve,” said Miller-Meeks. “Washington has allowed billions of taxpayer dollars to slip through the cracks because oversight hasn’t kept pace with the program’s growth. This commonsense legislation strengthens accountability, protects taxpayers, and helps preserve Medicaid for the Americans who truly depend on it.”

Medicaid Recovery Audit Contractors (RACs) are responsible for identifying and recovering improper Medicaid payments on behalf of states and taxpayers. Yet the GAO has repeatedly found significant weaknesses in the implementation and oversight of Medicaid RAC programs nationwide. Reporting requirements vary widely among states, transparency is often lacking, and broad exemptions from federal standards have resulted in inconsistent oversight and diminished effectiveness.

At the same time, a growing share of Medicaid expenditures now flows through managed care organizations, while existing payment integrity tools have not kept pace with this transformation. These shortcomings create significant blind spots, making it more difficult for federal and state officials to detect, prevent, and recover improper payments.

The Medicaid RAC Improvement Act of 2026 addresses these challenges by:

• Implementing key recommendations from the Government Accountability Office;

• Strengthening reporting requirements for Medicaid RAC programs;

• Increasing transparency and accountability across states;

• Expanding oversight of managed care payments; and

• Modernizing payment integrity efforts to better identify and recover improper payments while ensuring consistent oversight throughout the Medicaid program.

“Medicaid serves as a vital lifeline for millions of Americans, and we have a responsibility to ensure every dollar dedicated to the program is used appropriately and reaches those it is intended to help,” said Congressman Bilirakis. “Unfortunately, gaps in oversight and inconsistent enforcement have left taxpayers vulnerable and weakened our ability to identify improper payments. The Medicaid RAC Improvement Act strengthens transparency, accountability, and oversight so we can better safeguard taxpayer resources while preserving the integrity of this essential program.”

The Medicaid RAC Improvement Act of 2026 builds upon recommendations from the Government Accountability Office and reflects Congress’s ongoing commitment to improving program integrity while preserving access to care for Medicaid beneficiaries.

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