September 28, 2026
Mr. Evans of Colorado introduced the following bill; which was referred to the Committee on Energy and Commerce
To amend title XIX of the Social Security Act to promote electronic verification of non-emergency transportation services and applied behavior analysis services under the Medicaid program.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
Section 1. Short title
This Act may be cited as the Strengthening Tools for Oversight to Prevent Medicaid Fraud Act of 2026
or the STOP Medicaid Fraud Act of 2026
.
Sec. 2. Promoting electronic verification of non-emergency transportation services and applied behavior analysis services under the Medicaid program
Section 1903 of the Social Security Act (42 U.S.C. 1396b) is amended by adding at the end the following new subsection:
(cc) Electronic verification of non-Emergency transportation services and applied behavior analysis services
(1) In general
A State shall, with respect to medical assistance consisting of specified services furnished under the State plan (or waiver of such plan) of such State on or after January 1, 2027, require the use of an electronic verification system for such services. In the case the Secretary determines that a State is not in compliance with the preceding sentence—
(A)
the Secretary shall notify such State of such determination; and
(B)
the State shall submit to the Secretary, not later than 90 days after receiving such notification, a corrective action plan demonstrating how the State will come into compliance with such sentence by the date that is 1 year after the date of receipt of such notification.
(2) Implementation
Subject to paragraph (3), the provisions of subsection (l)(2) shall apply to a State’s implementation of the requirement for the use of an electronic verification system under paragraph (1) in the same manner as such provisions apply with respect to a State’s implementation of the requirement for the use of an electronic visit verification system under paragraph (1) of such subsection, except that—
(A)
the references to
personal care services, home health care services, or bothandpersonal care services or home health care servicesshall be treated as references tospecified services; and(B)
the reference to
electronic visit verification systemsshall be treated as a reference toelectronic verification systems.(3) Nonapplication to certain States
Paragraphs (1) and (2) shall not apply in the case of a State that, as of the date of the enactment of this subsection, requires the use of any system for the electronic verification of the furnishing of specified services, so long as the State continues to require the use of such system with respect to the electronic verification of such services.
(4) Definitions
In this subsection:
(A) Electronic verification system
The term
electronic verification systemmeans, with respect to specified services, a system under which the furnishing of such services is electronically verified with respect to each element specified in clauses (i) through (vi) of subsection (l)(5)(A).(B) Specified services
The term
specified servicesmeans non-emergency transportation services and applied behavior analysis services.