Insurance Fraud Accountability Act
Senate Panel Eyes Up to $200K Fines, Prison Time for Health Plan Enrollment Fraud
Stalled
No legislative action in over 90 days.
Legislative Progress
Key Points
- Creates new fines for agents and brokers who submit wrong information for health plan sign-ups, especially when it affects each person’s application.
- Sets much bigger penalties when an agent or broker knowingly submits false information, including fines up to $200,000 per affected person and possible prison time (up to 10 years).
- Requires a federal verification step for certain health plan sign-ups handled by agents or brokers, including proof the consumer agreed (like a consent form).
- Delays agent/broker commission payments until the consumer fixes eligibility or paperwork issues, and requires timely notices so people can quickly cancel unauthorized changes.
- Adds new oversight tools, including audits based on complaints or suspicious patterns, and a shared list of agents/brokers who have been suspended or terminated.
Impact Analysis
Personal Impact
How this policy affects specific groups of people
Milestones
Committee on Homeland Security and Governmental Affairs Senate Permanent Subcommittee on Investigations. Hearings held.
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Sent to a congressional committee for expert review. The committee decides whether this bill moves forward.
Introduced in Senate
The bill was officially filed and given a number. It now enters the legislative queue.
Votes
No votes have been recorded for this legislation yet.
Related News
4 articles
Legislation would introduce criminal penalties for health insurance fraud
Proposed by Sen. Ron Wyden and Reps. Deborah Ross and Kathy Castor, the Insurance Fraud Accountability Act creates criminal penalties for brokers who change ACA plans without consent. It establishes civil fines up to $200,000 and potential prison time for knowingly submitting false information.
Delegation for 3.14.25: Kathy Castor seeks to penalize insurers for unauthorized ACA plan changes
Rep. Kathy Castor reintroduced the Insurance Fraud Accountability Act to address 'system-gaming' by brokers in Florida and nationwide. The bill mandates a consent verification process and requires brokers to act in the best interest of the customer to prevent unauthorized enrollment changes.
Payer Roundup: Wyden introduces bill to institute criminal penalties against insurance brokers
Senate Finance Committee Chair Ron Wyden led a group of senators in introducing the Insurance Fraud Accountability Act. The bill targets 'predatory' brokers who enroll individuals in plans without permission to collect commissions, proposing strict new financial and criminal consequences.
Source Information
Document Type
Congressional Bill
Official Title
Insurance Fraud Accountability Act
Data Sources
Sponsor
Cosponsors
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