Medicaid Home and Community-Based Services Fraud Reporting Act

Summary#

The HCBS Anti-Fraud Reporting Act of 2026 would amend title XIX of the Social Security Act, which governs Medicaid. Its stated goal is to require reporting on waste, fraud, and abuse involving home and community-based services (HCBS) provided under Medicaid section 1915(c) waivers. The bill has been introduced and referred to a House committee; it is not law.

  • States would have to report to the U.S. Secretary of Health and Human Services on any waste, fraud, or abuse they detect in services under those waivers, and on efforts to prevent it.
  • The reporting would cover 2026 and each year after.
  • The bill adds this as a state commitment in section 1915(c)(2). The parent Act is not included in the supplied materials, so the exact effect on existing waiver approvals or renewals could not be verified.

What it means for you#

  • States: Would have to report the specified detected problems and prevention efforts to the Secretary. The bill does not set out how states must prepare or submit reports.
  • People receiving Medicaid HCBS and their providers: The bill does not directly change eligibility, services, payment rates, or provider duties.
  • The public: Reports go to the Secretary under the bill; it does not require that they be made public.

Money#

No cost information is in the available material.

  • The bill does not provide funding or an estimate for the reporting work.
  • States and the federal government may need staff time to prepare, receive, or handle reports; the cost is not stated.

What is unclear#

  • The bill does not define “waste,” “fraud,” or “abuse.”
  • It does not set report deadlines, a format, or the detail each report must include.
  • It does not say which state office would prepare reports or how reported information would be checked.
  • It does not say whether reports will be public or what happens if a state does not report.
  • The parent Act was not supplied, so how this new commitment applies to current waivers, and how it fits with existing reporting rules, could not be verified.

Case for#

  • A possible argument for the bill is that regular reporting could give federal officials information about detected problems and state prevention efforts.
  • Reports from different years could help show what states are finding and doing, though the bill does not require a particular way to compare them.
  • The bill focuses on reporting and prevention efforts; it does not itself change Medicaid recipients’ eligibility or services.

Case against#

  • The bill does not set common definitions or reporting standards, so states’ reports may differ and be hard to compare.
  • It requires reporting but does not specify how the Secretary should use the information or what follow-up is required.
  • One concern is that the reporting work could require state and federal staff time, while the bill provides no funding estimate.