PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Congressional Research Service
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People & committees
Rep. Suozzi, Thomas R. [D-NY-3] · D–NY
Legislative record
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Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Sep 15, 2026. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2026-09-10 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
The bill proposes funding changes for federal efforts to detect and prosecute health care fraud. It would extend certain oversight provisions to Affordable Care Act programs and add children’s health insurance to a program that compares Medicare and Medicaid data. It would also revise agency reporting requirements and require a study for Congress of how well the federal anti-fraud program performs.
2. Strengthening program integrity oversight for the Health Care Fraud and Abuse Control Program (a) Additional funding
title XIX and any program established under title I (or under the amendments made by such title) of the Patient Protection and Affordable Care Act (Public Law 111–148) that is administered by the Secretary.
(g) Inclusion of children’s health insurance program in medicare-Medicaid data match program
by striking report.—Not later than January 1 and inserting “report.— (A) In general Not later than April 1
the Comptroller General shall report to Congress the results of the study conducted under subsection (a), together with recommendations for such legislation and administrative action as the Comptroller General determines appropriate.
For the Departments of Health and Human Services and Justice, the bill would specify funding amounts of $490 million for fiscal year 2027, $520 million for 2028, and $570 million for 2029. After 2029, the funding limit would be the previous year’s limit increased by the percentage increase in the specified urban consumer price index, a measure of consumer prices.
(1) Departments of Health and Human Services and Justice Section 1817(k)(3)(A)(i) of the Social Security Act (42 U.S.C. 1395i(k)(3)(A)(i)) is amended
(V) for fiscal year 2027, $490,000,000; (VI) for fiscal year 2028, $520,000,000; (VII) for fiscal year 2029, $570,000,000; and (VIII) for each fiscal year after fiscal year 2029, the limit under this clause for the preceding fiscal year, increased by the percentage increase in the consumer price index for all urban consumers (all items; United States city average) over the previous year.
For the Health and Human Services Inspector General, the bill would specify $320 million for fiscal year 2027, $340 million for 2028, and $370 million for 2029. After 2029, funding would be no less than the previous year’s required amount increased by the percentage increase in the specified urban consumer price index.
(2) Office of the Inspector General of the Department of Health and Human Services Section 1817(k)(3)(A)(ii) of the Social Security Act (42 U.S.C. 1395i(k)(3)(A)(ii)) is amended
(X) for fiscal year 2027, $320,000,000; (XI) for fiscal year 2028, $340,000,000; (XII) for fiscal year 2029, $370,000,000; and (XIII) for each fiscal year after fiscal year 2029, not less than the amount required under this clause for the preceding fiscal year, increased by the percentage increase in the consumer price index for all urban consumers (all items; United States city average) over the previous year.
For the Federal Bureau of Investigation, the bill would specify $230 million for fiscal year 2027, $250 million for 2028, and $270 million for 2029. After 2029, the amount to be appropriated would be the previous year’s amount increased by the percentage increase in the specified urban consumer price index.
(3) Federal Bureau of Investigation Section 1817(k)(3)(B) of the Social Security Act (42 U.S.C. 1395i(k)(3)(B)) is amended
(ix) for fiscal year 2027, $230,000,000; (x) for fiscal year 2028, $250,000,000; (xi) for fiscal year 2029, $270,000,000; and (xii) for each fiscal year after fiscal year 2029, the amount to be appropriated under this subparagraph for the preceding fiscal year, increased by the percentage increase in the consumer price index for all urban consumers (all items; United States city average) over the previous year.
The bill would specify Medicare Integrity Program funding of $1.28 billion for fiscal year 2027, $1.38 billion for 2028, and $1.48 billion for 2029. After 2029, it would use the previous year’s appropriation with an adjustment under an existing statutory rule. It would make that adjustment rule apply to fiscal years 2011–2026 and years after 2029; the rule itself is not reproduced.
(4) Medicare Integrity Program Section 1817(k)(4) of the Social Security Act (42 U.S.C. 1395i(k)(4)) is amended
(viii) For fiscal year 2027, $1,280,000,000. (ix) For fiscal year 2028, $1,380,000,000. (x) For fiscal year 2029, $1,480,000,000. (xi) For each fiscal year after fiscal year 2029, the amount appropriated under this subparagraph for the preceding fiscal year, as increased pursuant to subparagraph (C)(ii).
in subparagraph (C)(ii), by striking For each fiscal year after 2010 and inserting For each of fiscal years 2011 through 2026, and for each fiscal year after fiscal year 2029.
The Medicare–Medicaid data comparison program would receive specified funding figures of $110 million for fiscal year 2027, $120 million for 2028, and $130 million for 2029. The bill also includes a previous-year funding formula for every year after 2028, referring to an existing adjustment rule. That language overlaps the specific 2029 amount, leaving its intended operation uncertain.
(5) Medicare-Medicaid data match program Section 1817(k)(4)(D) of the Social Security Act (42 U.S.C. 1395i(k)(4)(D)) is amended
(vi) $110,000,000 for fiscal year 2027. (vii) $120,000,000 for fiscal year 2028. (viii) $130,000,000 for fiscal year 2029. (ix) For each fiscal year after fiscal year 2028, the amount appropriated under this subparagraph for the preceding fiscal year, as increased pursuant to subparagraph (C)(ii).
The bill would expand the Inspector General provision to include programs established under title I of the Affordable Care Act, or amendments made by that title, when administered by the Health and Human Services Secretary. This qualification limits which Affordable Care Act programs the amendment covers.
(b) Expansion of investigative authority of the office of the inspector general of the department of health and human services
in the matter preceding subclause (I), by striking title XIX and inserting title XIX and any program established under title I (or under the amendments made by such title) of the Patient Protection and Affordable Care Act (Public Law 111–148) that is administered by the Secretary.
The bill would expressly add public and private delivery to one anti-fraud program provision and public or private plans or programs to the health-plan definition. The surrounding statutory language is not reproduced, so the supplied text does not establish the full scope of either provision.
(c) Clarification concerning the definition of health plan Section 1128C of the Social Security Act (42 U.S.C. 1320a–7c) is amended— (1) in subsection (a)(1)(B), by inserting public and private before delivery; and (2) in subsection (c), in the matter preceding paragraph (1), by inserting public or private before plan or program.
The bill would clarify that the amended funding paragraph does not limit the Health and Human Services Secretary, Attorney General, or Health and Human Services Inspector General from using its funds to detect or prosecute health care fraud and abuse, or to communicate with the public about health care fraud. This preserves authority rather than requiring particular investigations or communications.
Nothing in this paragraph shall be construed to limit the authority of the Secretary, the Attorney General, or the Inspector General of the Department of Health and Human Services to use funds made available under this paragraph to— (i) detect or prosecute health care fraud and abuse; and (ii) communicate with the public about health care fraud.
The bill would move the annual report deadline from January 1 to April 1.
by striking report.—Not later than January 1 and inserting “report.— (A) In general Not later than April 1
If the annual report were late, the Secretary and Attorney General would have to jointly explain the delay to specified congressional committees by April 1 and annually thereafter until submission. Notices would go to Senate Finance and Budget, and House Ways and Means, Budget, and Energy and Commerce.
If the annual report required under subparagraph (A) is not submitted to Congress by April 1 of the year, the Secretary and Attorney General shall jointly provide notice to the appropriate committees of Congress beginning not later than such April 1, and annually thereafter until such report is submitted to Congress, stating the reason for the delay.
the term appropriate committees of Congress means the Committees on Finance and Budget of the Senate and the Committees on Ways and Means, Budget, and Energy and Commerce of the House of Representatives.
In the provision governing funding allocation for Health and Human Services and Justice, the bill would replace “certify” with “agree.” The surrounding sentence is not supplied, so the precise procedural effect cannot be determined from this wording alone.
(f) Process for determining funding allocation for departments of justice and health and human services Section 1817(k)(3)(A)(i) of the Social Security Act (42 U.S.C. 1395i(k)(3)(A)(i)) is amended, in the matter preceding subclause (I), by striking certify and inserting agree.
Beginning in 2027, the bill would add the State Children’s Health Insurance Program to the Medicare–Medicaid data comparison program. Related amendments would add that program and its statutory title, title XXI, to the listed programs and legal references.
(g) Inclusion of children’s health insurance program in medicare-Medicaid data match program
under title XIX, and beginning with 2027, with respect to the State Children's Health Insurance Program under title XXI, for the purpose of
under this title, the Medicaid program established under title XIX, and the State Children's Health Insurance Program established under title XXI
in paragraph (2), by striking titles XI and XIX and inserting titles XI, XIX, and XXI.
Section 3 would require the Comptroller General to study the Health Care Fraud and Abuse Control Program’s performance and effectiveness. The required study topics would apply to the extent feasible and where data are available.
The Comptroller General of the United States (in this section referred to as the Comptroller General) shall conduct a study regarding the performance and effectiveness of the Health Care Fraud and Abuse Control Program. To the extent feasible and data are available, the study shall include the following:
Where feasible and supported by available data, the study would examine how Health and Human Services and Justice used appropriations to pursue program goals, how they measured performance, and how they committed program funds.
To the extent feasible and data are available, the study shall include the following:
(1) An analysis of how the Department of Health and Human Services and the Department of Justice have used their appropriations to achieve the goals of the Health Care Fraud and Abuse Control Program under section 1128C of the Social Security Act (42 U.S.C. 1320a–7c). (2) An analysis of performance assessments and other metrics the Department of Health and Human Services and the Department of Justice use to determine the performance and effectiveness of the Health Care Fraud and Abuse Control Program. (3) A description of how the Department of Health and Human Services and the Department of Justice obligated funds for the Health Care Fraud and Abuse Control Program.
Where feasible and supported by available data, the study would examine agency assessments, changes in key program outputs since the most recent specified Government Accountability Office report, and evidence about reducing fraud and abuse. Requiring this review does not establish that the program has reduced fraud.
To the extent feasible and data are available, the study shall include the following:
(4) An analysis of how the Department of Health and Human Services and the Department of Justice assess Health Care Fraud and Abuse Control activities and whether key program outputs have changed over time since the most recent Government Accountability Office report under section 1817(k)(6) of the Social Security Act (42 U.S.C. 1395i(k)(6)). (5) An analysis of evidence available regarding the effectiveness of the Health Care Fraud and Abuse Control Program in reducing health care fraud and abuse.
Where feasible and supported by available data, the study would also examine whether the annual program report is timely and how Health and Human Services and Justice could improve its timeliness.
To the extent feasible and data are available, the study shall include the following:
(6) An analysis of the timeliness of the annual Health Care Fraud and Abuse Control report under section 1817(k)(5) of the Social Security Act (42 U.S.C. 1395i(k)(5)) and how the Department of Health and Human Services and the Department of Justice could improve the timeliness of such report.
The Comptroller General would have to submit the study results to Congress within 16 months after enactment, together with any legislative and administrative recommendations the Comptroller General considers appropriate.
Not later than 16 months after the date of enactment of this Act, the Comptroller General shall report to Congress the results of the study conducted under subsection (a), together with recommendations for such legislation and administrative action as the Comptroller General determines appropriate.
The supplied actions snapshot, updated September 15, 2026, records House introduction on September 10, 2026, and referral that day to Ways and Means and Energy and Commerce for provisions within their respective jurisdictions. It does not establish subsequent action or enactment.
Source snapshot updated 2026-09-15T05:23:22Z.
2026-09-10: Introduced in House
2026-09-10: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
A closer look
Reviewed version: Introduced in House · 2026-09-10. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or separate policy rider was identified in the complete supplied introduced text. This conclusion is limited to that version and does not establish attachment history or the contents of other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for a particular outside recipient or locality was identified in the complete supplied introduced text. General agency and program funding is not automatically an earmark. This conclusion does not establish formal earmark status in other versions or accompanying materials.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
None identified in the reviewed text
No materially narrow preferential exemption, carve-out, or special benefit was identified in the complete supplied introduced text. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Full text preserved for this analysis. Legislative record snapshot: Sep 15, 2026. How PlainBill uses AI