Health Care Fraud Prevention and Enforcement Act
Sponsored By: Senator Cortez Masto, Catherine [D-NV]
Introduced
Summary
Boosts funding and tools to fight health care fraud. The bill creates new, targeted appropriations for HHS, DOJ, the HHS Office of Inspector General, the FBI, and Medicare integrity programs for 2027–2029 and then ties future increases to inflation, while expanding data matching and investigative authority to cover the Children’s Health Insurance Program and ACA-related programs.
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 3 benefits, 0 costs, 1 mixed.
Higher funding for fraud enforcement
This bill would raise yearly funding for federal health‑care fraud work. The FBI would get $230 million in FY2027, $250 million in FY2028, and $270 million in FY2029. HHS and the Justice Department would have program limits of $490 million (FY2027), $520 million (FY2028), and $570 million (FY2029). The Medicare Integrity Program would get $1.28 billion (FY2027), $1.38 billion (FY2028), and $1.48 billion (FY2029). The Medicare–Medicaid data‑match program would get $110 million (FY2027), $120 million (FY2028), and $130 million (FY2029). The HHS Office of Inspector General would get $320 million (FY2027), $340 million (FY2028), and $370 million (FY2029). After the listed years, each amount would rise each year by the Consumer Price Index for All Urban Consumers.
More oversight of fraud program
This bill would require the Government Accountability Office to study the Health Care Fraud and Abuse Control program and report to Congress within 16 months. The GAO must review use of appropriations, performance measures, obligations and outputs, and whether the program reduced fraud. The bill would move the HCFAC annual report deadline to April 1. If the annual report is not sent by April 1, HHS and the Justice Department must notify the Senate Committees on Finance and the Budget and the House Committees on Ways and Means, the Budget, and Energy and Commerce starting that April 1 and each year until the report is submitted.
Broader HHS fraud oversight authority
This bill would let the HHS Inspector General investigate programs established under the Affordable Care Act (title I) as well as Medicaid (title XIX). It would make clear that specified rules apply to both public and private delivery systems and to public or private plans. It would say that nothing in the changes limits the HHS Secretary, the Attorney General, or the HHS Inspector General from detecting, prosecuting, or publicly communicating about health‑care fraud. The bill would also replace the word 'certify' with 'agree' in one interagency allocation sentence.
CHIP added to data matching
This bill would allow State Children's Health Insurance Program (CHIP) records to be matched with Medicare and Medicaid data beginning in 2027. If enacted, CHIP enrollment would be checked against other program records to verify eligibility and detect improper payments. The bill also updates cross‑references in the law and inserts a timing clause affecting some related fiscal‑year language.
Sponsors & CoSponsors
Sponsor
Cortez Masto, Catherine [D-NV]
NV • D
Cosponsors
Sen. Grassley, Chuck [R-IA]
IA • R
Sponsored 8/6/2026
Sen. Wyden, Ron [D-OR]
OR • D
Sponsored 8/6/2026
Sen. Crapo, Mike [R-ID]
ID • R
Sponsored 8/6/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov