State Medicaid Program Integrity: Examining Fraud Risks and Oversight Deficiencies.

The House Committee on Energy and Commerce held a subcommittee hearing on June 26, 2026, titled "State Medicaid Program Integrity: Examining Fraud Risks and Oversight Deficiencies." The hearing focused on Medicaid fraud issues in Minnesota, California, New York, and Ohio, highlighting recent large-scale fraud takedowns involving millions of dollars in fraudulent claims. State Medicaid directors testified about their efforts to combat fraud, including provider revalidation, enhanced screening, data analytics investments, and law enforcement collaboration. The discussion also covered federal actions such as CMS withholding or deferring billions in Medicaid funding to certain states due to fraud concerns, which some members criticized as politically motivated. Witnesses emphasized the need for stronger federal-state partnerships, increased resources for fraud prevention, and balancing program integrity with ensuring access to care for vulnerable populations. Several members raised concerns about administrative burdens from federal mandates and the impact of funding deferrals on patient care. The hearing included multiple questions on provider enrollment reforms, data sharing across states, and the timeline for suspending payments upon credible fraud allegations. The committee encouraged continued oversight and legislative efforts to strengthen Medicaid program integrity while protecting beneficiaries.