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People & committees
Rep. Balderson, Troy [R-OH-12] · R–OH
Legislative record
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Referred to the House Committee on Energy and Commerce.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Oct 9, 2026. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2026-10-01 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
The proposed SMART Act would require the federal government to make standardized data analysis tools available to every State to help identify and prevent Medicaid fraud, waste, and abuse. States would gain access to data, investigative tools, and alerts about potentially improper activity. The bill would also require training and annual reports to Congress; these are proposed requirements, not evidence of achieved results.
This Act may be cited as the Strengthening Medicaid Analytics to Reduce Theft Act or the SMART Act.
the Secretary shall make available to each State standardized data analytic technologies for purposes of identifying and preventing fraud, waste, and abuse
access datasets and analytic outputs for purposes of identifying potentially improper billing, utilization, or enrollment patterns
use any dashboard or other investigative tools made available by the Secretary
provide States with actionable alerts based on such risk indicators.
The Secretary shall provide technical assistance and training to States
Not later than 1 year after the date of enactment of this subsection, and annually thereafter, the Secretary shall submit to Congress a report
Section 2 would add a new subsection to the Social Security Act. The Secretary would have to make the tools available to every State no later than 180 days after enactment, covering Medicaid State plans and plans operating under waivers.
Section 1903 of the Social Security Act (42 U.S.C. 1396b) is amended by adding at the end the following new subsection:
Beginning not later than 180 days after the date of the enactment of this subsection, the Secretary shall make available to each State standardized data analytic technologies for purposes of identifying and preventing fraud, waste, and abuse under the State plan (or waiver of such plan) of such State under this title.
The Secretary would have to ensure that the tools work with States' Medicaid claims, information, eligibility, and enrollment systems, and with other systems the Secretary determines are relevant to protecting the program from improper activity.
ensure that such technologies are interoperable with the mechanized claims processing and information retrieval systems described in subsection (a)(3)(A)(i), including Medicaid Management Information Systems and State eligibility and enrollment systems, and any other systems relevant to program integrity under this title, as determined by the Secretary
Each State would have to be able to review warning signs of possible fraud, waste, or abuse and receive alerts. States would also need access to data and analysis showing potentially improper billing, use of services, or enrollment patterns.
ensure that each State has the ability, through the use of such technologies, to— (i) review the risk indicators described in subparagraph (C)(i) and receive alerts regarding fraud, waste, and abuse vulnerabilities; (ii) access datasets and analytic outputs for purposes of identifying potentially improper billing, utilization, or enrollment patterns
States would have to be able to use any dashboards or investigative tools the Secretary makes available, receive alerts spanning multiple States or programs, conduct their own analyses, create State-level reports, and incorporate results into existing efforts to address improper activity.
(iii) use any dashboard or other investigative tools made available by the Secretary for the purposes of program integrity under this title; (iv) receive any program integrity alerts that apply across more than 1 State or program; (v) conduct State-specific analyses and generate State-level reports; and (vi) integrate analytic outputs from such technologies into existing State program integrity activities
The Secretary would have to use the tools to assess possible fraud, waste, or abuse risks involving providers, suppliers, and other entities participating in more than one State Medicaid plan or in multiple federal health care programs. These indicators would concern possible risk, rather than establish that wrongdoing occurred.
use such technologies to— (i) establish risk indicators that reflect the extent to which providers, suppliers, and other entities participating in more than 1 State plan under this title (or waiver of such plan), or participating in multiple Federal health care programs, may present a risk for fraud, waste, or abuse
The risk indicators would use billing, service-use, and enrollment data, plus other relevant federal health care program data selected by the Secretary. The Secretary would have to provide States with alerts they can act on based on those indicators.
based on— (I) billing data; (II) utilization data; (III) enrollment data; and (IV) any other relevant data related to a Federal health care program (as determined by the Secretary); and (ii) provide States with actionable alerts based on such risk indicators.
The Secretary would have to give States technical assistance and training on using the tools.
The Secretary shall provide technical assistance and training to States on how to use the technologies made available under paragraph (1).
The Secretary's first report to Congress would be due within one year after enactment, with reports annually thereafter. Reports would have to state how many States have access, how much each State uses the tools, and barriers to access or use.
Not later than 1 year after the date of enactment of this subsection, and annually thereafter, the Secretary shall submit to Congress a report on the technologies described in paragraph (1).
(A) The number of States with access to the technologies made available under paragraph (1), and a description of any barriers to such access. (B) The rate of utilization of such technologies by each State, and a description of any barriers to such utilization.
Each report would also have to count instances of possible fraud, waste, and abuse identified through the tools and estimate the associated overpayments identified and collected.
(C) The number of instances of possible fraud, waste, and abuse identified through the use of such technologies, and an estimate of the amount of overpayments identified and collected in connection with such instances.
The supplied official-actions snapshot, updated October 9, 2026, records introduction in the House and referral to the House Committee on Energy and Commerce on October 1, 2026.
Source snapshot updated 2026-10-09T20:37:45Z. 2026-10-01: Referred to the House Committee on Energy and Commerce. 2026-10-01: Introduced in House
A closer look
Reviewed version: Introduced in House · 2026-10-01. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No provision unrelated to the bill's main subject was identified in the complete supplied introduced text. This conclusion is limited to that version and does not establish the contents of other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places was identified in the complete supplied introduced text. This conclusion is limited to that version; formal earmark status cannot be fully assessed without accompanying materials.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
None identified in the reviewed text
No materially narrow carve-out, special exemption, or preferential treatment was identified in the complete supplied introduced text. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Full text preserved for this analysis. Legislative record snapshot: Oct 9, 2026. How PlainBill uses AI