Payment Prevention is becoming the defining principle of modern Medicaid program integrity. Federal agencies have intensified efforts to combat Medicaid fraud, highlighted by the March 2026 announcement of a new Task Force to Eliminate Fraud. At the same time, Congress

Drug pricing reform has become one of the most discussed strategies for controlling Medicaid costs. As states face rising enrollment, increasing healthcare expenditures, specialty medications, and growing program complexity, policymakers are searching for ways to reduce spending without compromising access