Introduction of the Medicaid Accountability Act of 2023

Floor Speech

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Mr. SABLAN. Mr. Speaker Pro Tempore, I rise today to introduce the Medicaid Accountability Act of 2023. My legislation would remove barriers to operating Medicaid Fraud Control Units in the territories, advancing our ability to recover taxpayer money through the investigation of Medicaid provider fraud, abuse, and neglect.

The U.S. territories are subject to a hard, statutory cap on federal Medicaid support, unlike the 50 states and the District of Columbia. As such, any spending for the operation of an MFCU is counted against the cap and subtracts from the amount of federal funding available for the coverage of healthcare services.

Congress has acknowledged this challenge. We acted to exempt MFCU spending from Puerto Rico's cap through P.L. 115-31, Consolidated Appropriations Act of 2017. This exemption was extended to the U.S. Virgin Islands through P.L. 115-123, Bipartisan Budget Act of 2018. We did not, however, extend this exemption to the other territories although all territories are statutorily required to operate an MFCU.

Congress has previously agreed that spending towards systems improvement measures should be exempt from the cap. In addition to MFCUs, Congress has exempted spending related to Transformed Medicaid Statistical Information System, Medicaid Electronic Health Record Incentive Program, and the design and operation of the claims and eligibility systems.

Without such exemptions, territories must choose between covering healthcare services or making systems improvements. And faced with various emergencies--from natural disasters to a pandemic--in recent years, territories have prioritized the coverage of healthcare services. Furthermore, certain territories have repeatedly exhausted their limited block grant, leaving no federal funding to support systems improvement measures.

My bill, the Medicaid Accountability Act of 2023, plugs a gap in our nation's ability to protect taxpayer money. By extending the exemption on MFCU spending to all territories, Congress can promote the success of the territories in meeting statutory obligations to combat healthcare fraud and safeguard our Medicaid population from abuse, neglect, and misappropriation of funds.

I thank my colleagues who joined me in introducing this legislation-- Mr. Moylan, Ms. Plaskett, and Ms. Radewagen.

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