The STOP FRAUD in Medicaid Act directs state Medicaid fraud control units to investigate and prosecute cases where beneficiaries fraudulently apply for or receive Medicaid benefits, expanding their authority beyond investigating provider fraud. Currently, these state units focus primarily on healthcare providers who commit fraud against the Medicaid program; this bill requires them to also target individuals who deceive the system to obtain or maintain benefits they don't qualify for. The legislation takes effect 180 days after enactment and amends existing Social Security Act provisions governing Medicaid fraud investigation and state plan requirements. The bill does not appear to include new federal funding in the text provided, leaving implementation dependent on existing state Medicaid fraud control budgets and resources. This change would shift enforcement focus to beneficiary-level fraud such as misrepresenting income or household composition to qualify for coverage.
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