One Official, One Job: Pfluger’s Bill Puts a Name on Medicaid’s Money Problems

WASHINGTON, D.C. — Congressman August Pfluger (TX-11) introduced the Medicaid Integrity and Fiscal Responsibility Act, which would require each state Medicaid program to designate an individual as the person primarily responsible for fiscal duties associated with the state’s Medicaid state plan or waiver. 

The official in charge would be responsible for ensuring that the state establishes appropriate policies, procedures, monitoring systems, and corrective actions to carry out these responsibilities. 

The Medicaid Integrity and Fiscal Responsibility Act would make the designated individual accountable for processing claims accurately and on time, preventing fraud, waste, abuse, and improper payments, reporting expenditures accurately to HHS, and maintaining strong financial controls. This ensures taxpayer dollars are protected, and Medicaid spending follows federal requirements.

"Every dollar lost to fraud, waste, and improper payments is a dollar taken from patients who depend on Medicaid and from the taxpayers who fund it," Pfluger stated. "My legislation puts a single, accountable official in charge of Medicaid claims processing, payment integrity, financial reporting, and internal controls in each state. This is a commonsense step to protect Medicaid for the Americans it was meant to serve."

Pfluger's legislation was included in the House Energy and Commerce Committee's fraud-fighting health care package, advancing a broader effort to crack down on improper payments and protect Medicaid for the patients who depend on it. Read more about the package HERE.