14. Department of Health and Human Services · Minor
Pay states a contingency fee for cutting Medicaid waste and fraud
Printed page 467 14. Department of Health and Human Services
“Incentivize states. An enhanced contingency fee should be paid to states that successfully increase their efforts to decrease waste, fraud, and abuse.”
What has happened
- Not started
No enhanced contingency fee exists. CMS's CRUSH request for information asks the question — "What incentives could be put in place for states to proactively engage in program integrity efforts, and what new penalties might be necessary to address non-compliance by states?" — but proposes nothing, and the only enacted change runs the other way: Public Law 119-21 § 71106 widens the erroneous-excess-payment penalty against States from fiscal year 2030. Asking what an incentive might look like is not creating one.
Research log
What was searched, and what didn’t count as evidence
Research notes
- The CRUSH RFI was read in full at https://www.govinfo.gov/content/pkg/FR-2026-02-27/html/2026-03968.htm; “contingency” appears nowhere in it. Searched: the titles of the bills we keep and search, for “contingency fee” → 0; Federal Register “contingency fee” in-window → nothing in a Medicaid context.
- The planned CMS-2450 rulemaking (Unified Agenda RIN 0938-AV70, NPRM scheduled July 2026, not yet published) is about program-integrity oversight of States, not about paying them a share of savings.
- Action
- create
- Object
- enhanced contingency fee for state program integrity efforts
- ID
- 1277