H.R. 10636 — Medicaid Fraud Prevention Act

This bill requires state Medicaid programs to regularly assess their programs for fraud and take corrective actions. Specifically, states must complete a fraud risk assessment on at least an annual basis, implement a corrective action plan to address any identified vulnerabilities, and report on the results to the Centers for Medicare & Medicaid Services (CMS). The CMS must analyze this information and annually report the information to Congress. The fraud risk assessments must include a comprehensive assessment of the risks of fraud across the entirety of a state's Medicaid program, including with respect to managed care entities and eligibility and enrollment systems. The assessments mus...