There’s a big, swaggering bill moving through Congress—the ‘Big, Beautiful Bill’ (BB Bill)—and if you’re a Medicaid provider, it’s time to take notice. Whether it ends up trimmed by the Senate or not, the House version signals major changes.
If your compliance program is still a dusty binder marked ‘someday,’ this is your moment. Surviving the future of Medicaid will take more than good intentions—it’s going to require a compliance plan that actually works.
What’s in the House Version of the BB Bill?
- Medicaid Caps and Block Grants
States get a set amount of federal funds—less flexibility in crisis, more state-level cuts. - Expanded Waiver Authority
States can reshape Medicaid eligibility and benefits with fewer limits. - Elimination of Optional Benefits
Optional services like therapy and in-home care may disappear. - New Compliance Mandates
More audits, stricter documentation rules, and a focus on ‘program integrity.’ - Telehealth with Strings
It expands—but only with rigorous outcome tracking and compliance reporting.
Why Compliance Can’t Be an Afterthought
This is the era of ‘show your work.’ The bill demands that providers operate like high-performing systems—accountable, auditable, and well-documented. That means real-time audit readiness, updated policies, and staff training that sticks.
This isn’t just a legal box to check—it’s peace of mind. And I help providers build exactly that.
How to Start Preparing
- Assess your risk: What services rely on Medicaid? What’s outdated?
2. Build or update your compliance plan. I can help.
3. Monitor state Medicaid changes closely.
4. Speak up—your voice matters more than ever.
If you work in Medicaid, you already know the ground is never really stable. But the Big, Beautiful Bill isn’t just a tremor—it’s a tectonic shift. Let’s make sure your program is ready—not just for audits, but for the future.
Want help making sure your compliance program is more than a binder on a shelf? Let’s talk. The team at Sandberg Phoenix specializes in building real, working systems that protect providers, preserve funding, and give you peace of mind. Contact us to get started.
