Combating Deceptive Practices in Assistance Programs Act of 2026

Bill Number

H.R. 7713

Origin Chamber

House

Congress

119th Congress, Session 2

Policy Area

Health

Status

Introduced

Latest Action

2026-02-25: Referred to the House Committee on Energy and Commerce.

Last Updated

2026-03-27T21:02:55Z

AI-Generated Summary

Purpose of the Legislation

This bill, titled the "Combating Deceptive Practices in Assistance Programs Act of 2026," aims to modify eligibility rules for personal care services under the Medicaid program. Personal care services help individuals with everyday tasks like bathing or dressing when they cannot do these on their own. The goal is to ensure these services are available only to those who truly need them, potentially reducing misuse or fraud in the program.

Key Provisions

• Eligibility Requirement: The bill adds a specific condition for receiving personal care services through Medicaid. Services can only be provided to individuals who are unable to perform at least 3 "activities of daily living" (ADLs). ADLs are basic self-care tasks, such as eating, toileting, transferring (moving from bed to chair), bathing, dressing, and continence, as defined in the Internal Revenue Code (a U.S. tax law section related to long-term care insurance).
• Effective Date: The change takes effect for Medicaid services provided on or after January 12, 2027.

Significant Changes to Existing Law

• Under current Medicaid law (Section 1905(a)(24) of the Social Security Act), states can offer personal care services to eligible individuals without a strict federal definition of need based on ADLs.
• This bill introduces a uniform federal threshold: inability to perform 3 or more ADLs. This tightens eligibility, making it harder for some to qualify unless they meet this specific level of impairment, which could standardize rules across states but limit broader access.

Potential Impacts

• On Government Agencies: State Medicaid programs may need to update assessment processes to verify ADL limitations, potentially increasing administrative costs initially but reducing long-term spending by limiting services to those with greater needs. The federal government could see savings in Medicaid funding.
• On Citizens: Individuals with disabilities or chronic conditions who cannot perform 3 or more ADLs may continue or gain access to services, but those with milder needs might lose coverage, affecting their independence and quality of life. Families or caregivers relying on these services could face disruptions.
• On International Relations: No direct impact, as this is a domestic health policy focused on U.S. Medicaid.

Main Stakeholders Affected

• Medicaid Beneficiaries: Primarily low-income seniors, people with disabilities, and others needing personal care, who may see changes in service availability.
• State Medicaid Agencies: Responsible for implementing and enforcing the new eligibility rules, including assessments and appeals.
• Healthcare Providers and Caregivers: Agencies or individuals delivering personal care services could experience shifts in client volume and reimbursement.
• Advocacy Groups: Organizations for disability rights or elder care may support or oppose the bill based on access concerns.
• Taxpayers: Indirectly affected through potential federal and state budget savings or reallocations in Medicaid spending.

Notable Legal, Constitutional, or Political Implications

• Legal: The amendment relies on an existing tax code definition for ADLs, ensuring consistency without creating new terms, but it could lead to legal challenges if seen as overly restrictive under Medicaid's goal of providing essential health services. States retain flexibility in how they assess ADLs, but federal oversight may increase to prevent fraud.
• Constitutional: No major issues, as it aligns with Congress's authority to regulate federal spending programs like Medicaid. It does not infringe on individual rights directly but could raise equal protection concerns if implementation disproportionately affects certain groups (e.g., based on disability type).
• Political: The bill's focus on combating "deceptive practices" suggests an anti-fraud motive, appealing to fiscal conservatives, but it may spark debate over balancing cost savings with access to care, especially in an aging population. As an introduced bill (H.R. 7713, referred to the House Committee on Energy and Commerce), its passage depends on broader healthcare reform priorities.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Schweikert, David [R-AZ-1]

Recent Actions

• 2026-02-25: Referred to the House Committee on Energy and Commerce.
• 2026-02-25: Introduced in House
• 2026-02-25: Introduced in House

Bill Versions

• Combating Deceptive Practices in Assistance Programs Act of 2026 — issued 2026-02-25 — PDF (2 pages)