To amend title XVIII of the Social Security Act to authorize the Secretary of Health and Human Services to enter into contracts with recovery audit contractors to perform prepayment reviews under the Medicare program.
About This Bill
Committee
Latest Action · May 13, 2026
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
This bill authorizes the Secretary of Health and Human Services to contract with recovery audit contractors to review Medicare claims before payment is made, rather than only after overpayments have already been sent out. The contractors would be paid based on the amount of improper payments they prevent, with a methodology designed to encourage timely and accurate prevention of fraudulent or incorrect claims without unfairly targeting certain types of claims. The bill affects Medicare providers and beneficiaries by potentially reducing erroneous payments before they occur. Funding for these prepayment review contracts would come from transfers between the Hospital Insurance Trust Fund and the Supplementary Medical Insurance Trust Fund based on the proportion of improper payments prevented in each program. The Secretary must issue implementing regulations within one year of the bill's enactment, including details on payment methodology and how savings will be calculated.
Take Action
Your position
Add a comment
to comment on this bill.
Annotate the text
Highlight any passage on the Summary or Full Text tab to attach a note. Annotations appear on the Annotations tab.