Medicare and Medicaid Fraud Prevention Act

This bill aims to stop fraud in Medicaid by making states regularly check if enrolled providers are actually alive. States must verify, during enrollment and re-enrollment, that a provider isn’t listed as deceased in the Social Security Administration’s Death Master File. After enrollment, states have to keep checking at least every three months. These checks start on January 1, 2027, and continue on a quarterly basis to prevent payments to providers who have died .

In practice, this means fewer mistaken or fraudulent payments and better protection of Medicaid funds. Providers may see more routine verification steps, but patients should not notice changes in their care because the focus is on billing safeguards, not services.

• Who is affected: State Medicaid programs and the providers and suppliers they enroll.
• What changes: States must check the Death Master File during enrollment and re-enrollment, then at least quarterly afterward to confirm providers are not deceased .
• When: The ongoing checks begin January 1, 2027.