• The bill, titled the "Medicaid Integrity and Fiscal Accountability Act," amends title XIX of the Social Security Act to require each state to designate a single individual as primarily responsible for certain fiscal duties under Medicaid, beginning January 1, 2028.
• The designated individual must ensure accurate and timely claims processing, payment integrity (including identifying and preventing fraud, waste, abuse, and improper payments), and appropriate financial reporting.
• The individual is also responsible for establishing and maintaining controls to ensure that Medicaid expenditures comply with all applicable federal requirements.

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