STOP FRAUD in Medicaid Act

This bill would amend the Medicaid program under the Social Security Act to require state Medicaid fraud control units to actively investigate and prosecute instances of fraud committed by Medicaid beneficiaries. Currently, these state units focus primarily on provider fraud, which involves healthcare providers billing Medicaid improperly. This legislation would expand their mandate to include beneficiary fraud, such as cases where individuals misrepresent their eligibility, income, or other information to obtain or maintain Medicaid benefits.

If enacted, the bill would shift resources and enforcement priorities within state Medicaid fraud control units to address fraud on the beneficiary side of the program. This could result in more investigations and prosecutions of individuals accused of Medicaid fraud, potentially leading to criminal charges, restitution requirements, or program disenrollment. The practical impact would depend on how states implement the requirement and allocate funding, but it would likely increase enforcement actions against beneficiaries suspected of fraudulent activity.