This bill requires state Medicaid fraud control units to conduct annual audits of high-risk healthcare providers and suppliers starting one year after the law takes effect. The audits will focus on identifying fraud, waste, and abuse in the Medicaid program, with state units working alongside federal health inspectors and state Medicaid administrators. States must report their audit findings annually, including details about any overpayments they identified and collected. The bill defines "high-risk providers" as those with suspicious billing patterns, prior audit problems, unusual payments, questionable ownership changes, or credible fraud allegations. States that fail to conduct the required audits can still maintain their certification if they submit and implement an acceptable corrective action plan approved by the federal government. The legislation affects state Medicaid agencies and providers enrolled in Medicaid programs across the country.