Wittman Cosponsors Helping Encourage Lawful Payments and Strengthen Transparency, Anti-fraud, Tips, and Enforcement Strategies Act (HELP STATES) Act

WASHINGTON, D.C. – Congressman Rob Wittman (VA-01) co-led the introduction of the Helping Encourage Lawful Payments and Strengthen Transparency, Anti-fraud, Tips, and Enforcement Strategies (HELP STATES) Act, legislation to strengthen states’ ability to identify and recover fraudulent Medicaid payments.

Congressman Tom Kean (NJ-07) introduced the legislation alongside Reps. Wittman, Jen Kiggans (VA-02), David Valadao (CA-22), Young Kim (CA-40), and Rob Bresnahan (PA-08). The HELP STATES Act would allow states to retain a portion of the federal share of Medicaid funds recovered from fraud and require those dollars to be reinvested in efforts to prevent, detect, and combat Medicaid fraud.

“Every dollar lost to fraud is a dollar that cannot be used to provide care for Americans who rely on Medicaid,” said Rep. Wittman. “I am proud to join my colleagues in introducing the HELP STATES Act to give states a stronger incentive to identify and recover fraudulent payments while ensuring those recovered funds are reinvested in protecting the integrity of the Medicaid program. We owe it to taxpayers and Medicaid enrollees to safeguard these resources and hold those who defraud the system accountable.”

Background:

Under current law, when a state recovers an improper Medicaid payment attributable to fraud, it generally must return the federal government’s share of that recovery. The HELP STATES Act would allow a state to retain up to 25% of the federal share of a qualifying fraud recovery.

States would not be permitted to use these retained funds for general spending. Instead, the money would be required to support Medicaid program-integrity activities aimed at preventing, identifying, and recovering fraudulent payments.

The legislation would take effect following an 18-month implementation period, providing the Centers for Medicare & Medicaid Services (CMS) and states time to establish procedures for determining eligible recoveries, calculating the federal share subject to the incentive, and establishing applicable state reporting requirements.