Health Care Fraud Prevention and Enforcement Act
Sponsored By: Representative Suozzi, Thomas R. [D-NY-3]
Introduced
Summary
Strengthen federal health care fraud enforcement. This bill would expand funding, investigative authority, data sharing, and oversight across HHS, DOJ, the FBI, and the HHS Office of Inspector General to target fraud in Medicare, Medicaid, CHIP, and Affordable Care Act programs.
Show full summary
- Families and children on CHIP: The bill would add the State Children’s Health Insurance Program to the Medicare-Medicaid data match. That data-match expansion would begin in 2027 to help detect improper payments.
- Federal enforcement and program integrity teams: It would provide targeted funding for HHS, DOJ, the HHS OIG, the FBI, and Medicare integrity activities for 2027 through 2029, with a consumer price index based growth rule for later years. The HHS OIG’s investigative authority would extend to Medicaid and ACA-related programs and the bill changes some funding allocation rules from certification to agreement.
- Oversight and accountability for Congress and watchdogs: The bill would require an annual congressionally mandated performance and program integrity report by April 1 with a required notice if delayed. It also directs a Government Accountability Office study and report on the Health Care Fraud and Abuse Control Program within 16 months of enactment.
Personalized for You
How does this bill affect your finances?
Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
More money for health fraud enforcement
This bill would give more money for federal health care fraud work. It would authorize $230 million for the FBI in FY2027, $250 million in FY2028, and $270 million in FY2029, with later years rising by the annual CPI‑U change. It would set HHS and DOJ annual limits at $490 million for FY2027, $520 million for FY2028, and $570 million for FY2029, with later years indexed to CPI‑U. It would fund the HHS Inspector General ($320M, $340M, $370M for FY2027–29) and increase the Medicare Integrity Program ($1.28 billion, $1.38 billion, $1.48 billion for FY2027–29). The bill would also add CHIP to the Medicare–Medicaid data match and fund that effort ($110M, $120M, $130M for FY2027–29).
Stronger oversight for federal health programs
The bill would expand HHS Office of Inspector General investigative authority to cover Medicaid (title XIX) and programs created under title I of the Affordable Care Act that HHS runs. It would clarify that the law covers both public and private delivery systems and plans. The bill would say agencies may use covered funds to detect or prosecute health care fraud and to tell the public about fraud. It would also change an interagency wording from 'certify' to 'agree' in the funding allocation process.
Sponsors & CoSponsors
Sponsor
Suozzi, Thomas R. [D-NY-3]
NY • D
Cosponsors
Rep. Tenney, Claudia [R-NY-24]
NY • R
Sponsored 9/10/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov