What This Bill Does
The HCBS Anti-Fraud Reporting Act of 2026 would amend Medicaid law to require states to report to the Secretary of Health and Human Services on fraud-related issues in home and community-based services (HCBS) waiver programs. Starting in 2026 and each year after, states would have to disclose any waste, fraud, or abuse they detect in those services and describe the steps they are taking to prevent it. The bill applies to states participating in section 1915(c) Medicaid waivers, which are a major way states finance long-term services for people who need help at home or in community settings. It does not create a new benefit or funding stream; it creates a reporting requirement tied to existing Medicaid waiver administration.
- Applies to Medicaid section 1915(c) home and community-based services waivers.
- Requires state reporting starting in 2026 and each year after.
- States must report any waste, fraud, or abuse they detect.
- States must also report efforts taken to prevent waste, fraud, and abuse.
- The bill amends section 1915(c)(2) of the Social Security Act.
Who This Bill Affects
For people who rely on Medicaid home and community-based services, this bill would not change eligibility or benefits directly, but it could lead to more state reporting on fraud and prevention efforts in the programs they use. For taxpayers and program administrators, it could improve visibility into waste, fraud, and abuse in section 1915(c) waivers, while also adding a new compliance task for states.
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- Medicaid program integrity officials They would likely support the bill because it creates a regular reporting channel on fraud and prevention efforts in HCBS waivers. That can help federal and state officials compare practices, spot weak controls, and identify patterns of abuse across states.
- Taxpayers concerned about government waste They may favor the bill because it focuses on waste, fraud, and abuse in a large public program without changing benefits. Requiring states to disclose what they find could increase accountability for how Medicaid dollars are spent.
- Families relying on home-based long-term care They may support stronger oversight if it helps protect scarce HCBS resources from misuse. Better fraud reporting could help preserve services for people who depend on them to remain in their homes and communities.
- State Medicaid administrators They may oppose the bill because it adds another reporting obligation to an already complex waiver system. Even if the requirement is limited, states would need staff time and systems to track and report fraud findings and prevention efforts each year.
- Home and community-based service providers Providers may worry that the new reporting requirement could lead to more scrutiny and paperwork, especially in a sector with many small agencies and individualized care arrangements. They may argue the bill does not provide resources to help providers comply or to investigate alleged fraud.
- Advocates for people with disabilities and older adults Some may be cautious if the reporting mandate is seen as a step toward more administrative barriers in HCBS. They may prefer direct investments in oversight staff or service quality rather than a reporting requirement that does not itself expand care or enforcement.
Key Implications
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““with respect to 2026 and each subsequent year””
The reporting duty begins in 2026 and continues annually. States would need an ongoing process for collecting and submitting fraud-related information, not a one-time report.
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““the State will report to the Secretary””
The information goes to the federal health secretary, meaning oversight is being centralized at the federal level. That can improve visibility across states, but it also creates a federal compliance obligation.
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““any waste, fraud, or abuse detected by the State””
States must disclose problems they actually find in their waiver programs. This could encourage more active monitoring, but it also means the report depends on how much detection capacity a state has.
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““efforts taken by the State to prevent such waste, fraud, and abuse””
States must describe prevention steps, not just incidents. That could include internal controls, audits, or other safeguards, but the bill does not specify which measures count.
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““services furnished under such waiver””
The requirement is limited to services provided under section 1915(c) HCBS waivers. It does not apply to all Medicaid services, only this long-term care-related waiver category.
Latest Status
June 3, 2026
Referred to the House Committee on Energy and Commerce.
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Ask AI about this billData sourced from api.congress.gov.