STOP Medicaid Fraud Act of 2026

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10618 Introduced in House (IH)]

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119th CONGRESS
  2d Session
                               H. R. 10618

  To amend title XIX of the Social Security Act to promote electronic 
   verification of non-emergency transportation services and applied 
         behavior analysis services under the Medicaid program.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                           September 28, 2026

Mr. Evans of Colorado introduced the following bill; which was referred 
                to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL

 
  To amend title XIX of the Social Security Act to promote electronic 
   verification of non-emergency transportation services and applied 
         behavior analysis services under the Medicaid program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Strengthening Tools for Oversight to 
Prevent Medicaid Fraud Act of 2026'' or the ``STOP Medicaid Fraud Act 
of 2026''.

SEC. 2. PROMOTING ELECTRONIC VERIFICATION OF NON-EMERGENCY 
              TRANSPORTATION SERVICES AND APPLIED BEHAVIOR ANALYSIS 
              SERVICES UNDER THE MEDICAID PROGRAM.

    Section 1903 of the Social Security Act (42 U.S.C. 1396b) is 
amended by adding at the end the following new subsection:
    ``(cc) Electronic Verification of Non-Emergency Transportation 
Services and Applied Behavior Analysis Services.--
            ``(1) In general.--A State shall, with respect to medical 
        assistance consisting of specified services furnished under the 
        State plan (or waiver of such plan) of such State on or after 
        January 1, 2027, require the use of an electronic verification 
        system for such services. In the case the Secretary determines 
        that a State is not in compliance with the preceding sentence--
                    ``(A) the Secretary shall notify such State of such 
                determination; and
                    ``(B) the State shall submit to the Secretary, not 
                later than 90 days after receiving such notification, a 
                corrective action plan demonstrating how the State will 
                come into compliance with such sentence by the date 
                that is 1 year after the date of receipt of such 
                notification.
            ``(2) Implementation.--Subject to paragraph (3), the 
        provisions of subsection (l)(2) shall apply to a State's 
        implementation of the requirement for the use of an electronic 
        verification system under paragraph (1) in the same manner as 
        such provisions apply with respect to a State's implementation 
        of the requirement for the use of an electronic visit 
        verification system under paragraph (1) of such subsection, 
        except that--
                    ``(A) the references to `personal care services, 
                home health care services, or both' and `personal care 
                services or home health care services' shall be treated 
                as references to `specified services'; and
                    ``(B) the reference to `electronic visit 
                verification systems' shall be treated as a reference 
                to `electronic verification systems'.
            ``(3) Nonapplication to certain states.--Paragraphs (1) and 
        (2) shall not apply in the case of a State that, as of the date 
        of the enactment of this subsection, requires the use of any 
        system for the electronic verification of the furnishing of 
        specified services, so long as the State continues to require 
        the use of such system with respect to the electronic 
        verification of such services.
            ``(4) Definitions.--In this subsection:
                    ``(A) Electronic verification system.--The term 
                `electronic verification system' means, with respect to 
                specified services, a system under which the furnishing 
                of such services is electronically verified with 
                respect to each element specified in clauses (i) 
                through (vi) of subsection (l)(5)(A).
                    ``(B) Specified services.--The term `specified 
                services' means non-emergency transportation services 
                and applied behavior analysis services.''.
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