Four Republican state representatives said in a guest opinion that while expanding Medicaid access is appropriate, Kentucky must implement strong oversight and accountability measures to protect the program from fraud and waste.

Representatives Ken Fleming, Scott Sharp, Wade Williams, and Kim Moser said the state's Medicaid program, which serves about one in three Kentuckians, requires more than good intentions and funding to operate effectively. Their comments follow a recent $16.2 million settlement by Addiction Recovery Care and affiliates with federal prosecutors over Medicaid fraud allegations.

"Without those protections, program accountability lessens, creating an environment that fosters and attracts bad actors seeking to improperly benefit from Kentucky's Medicaid dollars," the representatives said in a statement, arguing that such fraud diverts resources from intended beneficiaries and threatens the program's long-term viability.

The representatives noted that despite Medicaid funding more than doubling in recent years, there has not been a corresponding improvement in overall health outcomes for beneficiaries. They characterized guardrails not as unnecessary barriers but as critical protections that preserve access to care while safeguarding against fraud, waste, and abuse.

Addiction Recovery Care, once Kentucky's largest addiction treatment provider, agreed in July to pay $16.2 million to resolve allegations that it submitted fraudulent Medicaid claims through billing practices including falsely representing clinician qualifications and billing group therapy sessions as individual therapy to obtain higher reimbursement rates.

The representatives cited recent federal efforts to combat Medicaid fraud, noting that the Centers for Medicare and Medicaid Services reported $187 million in provider and supplier payment suspensions in the first quarter of 2026. "States play an important role in carrying out these efforts, as fraud of any kind undermines the program's integrity," they said.

Their comments align with legislative action from the 2025 session. The General Assembly established the Medicaid Oversight and Advisory Board, which meets monthly to review Medicaid policies, practices, and spending. Fleming serves as the board's House chair.

The legislature also passed a two-year budget that fully funds Medicaid while directing the administration to identify savings through outdated or ineffective programs and unused contracts. Lawmakers approved the Kentucky Medicaid Reform Act aimed at improving services and reducing fraud across the program.