Health Care Fraud Prevention and Enforcement Act

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Introduced

In Committee

Passed One Chamber

Passed Both Chambers

Signed into Law

Read twice and referred to the Committee on Finance.

More funding to fight healthcare fraud in Medicare, Medicaid, and CHIP.

This bill would set aside billions of dollars to strengthen efforts against healthcare fraud. It would give agencies more money to investigate fraud and expand their reach to protect more health programs. It would also require a study on how well these efforts are working.

What Would Change

Today, various government agencies receive specific funding to fight healthcare fraud in Medicare and Medicaid, with funding limits generally through the government's budget year 2026. If this bill passes, these agencies would receive significantly increased funding starting in the government's budget year 2027, totaling over $2.4 billion in the first year alone. Also, the Children's Health Insurance Program (CHIP) would be included in the data matching program to detect fraud, and the HHS Inspector General would gain expanded power to investigate Affordable Care Act programs.

Key Provisions

Sets aside $490,000,000 for the Departments of Health and Human Services and Justice in the government's budget year 2027 to fight healthcare fraud, with more funding in later years.
Sets aside $320,000,000 for the Office of the Inspector General of HHS in the government's budget year 2027 to investigate healthcare fraud, with more funding in later years.
Sets aside $230,000,000 for the Federal Bureau of Investigation in the government's budget year 2027 for healthcare fraud activities, with more funding in later years.
Sets aside $1,280,000,000 for the Medicare Integrity Program in the government's budget year 2027 to prevent fraud, with more funding in later years.
Sets aside $110,000,000 for the Medicare-Medicaid Data Match Program in the government's budget year 2027 to identify fraud, with more funding in later years.

View on Congress.gov

S 5326 · 119th Congress · AI Summary by gemini-2.5-flash · 9/10

Health Care Fraud Prevention and Enforcement Act

What Would Change

Key Provisions

Lobbying Activity