Putting an N to Learing about Fraud Act
Sponsored By: Senator Ernst, Joni [R-IA]
Introduced
Summary
This bill would create a framework to identify, deter, and recover fraud by strengthening fraud detection and recovery in child care and health programs. It targets attendance-based child care payments, fast alerts for sudden local payment spikes, and tougher audit and reporting rules.
Your PRIA Score
Personalized for You
How does this bill affect your finances?
Sign up for a PRIA Policy Scan to see your personalized alignment score for this bill and every other piece of legislation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
3 provisions identified: 1 benefits, 0 costs, 2 mixed.
New rules for child care payments
If enacted, lead agencies would not have to prepay child care providers. Payments would be reimbursed in a timely way based on actual attendance, not just enrollment. State plans would have to assure attendance-based billing. Child care providers who get these payments would need to keep attendance and service records for 7 years and make them available for audits by federal officials.
New checks on health payment spikes
If enacted, HHS would have to notify the HHS Inspector General within 60 days when Medicare, Medicaid/CHIP, or local qualified health plan payments or provider counts jump by more than 100% in a single year in a ZIP code and county. Health exchanges would collect annual data from each plan to let HHS check for those jumps. CHIP would follow the same rules as Medicaid. Not later than 5 years after enactment and each year after, the HHS Inspector General would identify programs with at least a 400% increase over five years and audit them. The Medicare and exchange rules would take effect 180 days after enactment, and Medicaid/CHIP changes generally take effect 180 days after enactment with a state-law timing rule.
Rules to recover improper payments
If enacted, the Office of Management and Budget would issue guidance telling all agencies to recover improper payments. Inspector General reports to Congress would also have to state how much money each agency recovered from improper payments in the covered fiscal year. These changes would take effect upon enactment.
Sponsors & CoSponsors
Sponsor
Ernst, Joni [R-IA]
IA • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov