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Congressional Research Service
Version 00 · Introduced in Senate · Jul 22, 2010
Medicare and Medicaid Fraud Enforcement and Prevention Act of 2010 - Amends title XI of the Social Security Act (SSA) to increase criminal penalties for both felony and misdemeanor fraud under SSA titles XVIII (Medicare) and XIX (Medicaid).
Adds a new offense of distribution of one or more Medicare or Medicaid beneficiary identification numbers or billing privileges with the intent to defraud.
Applies civil monetary penalties to: (1) conspiracy to make false statements or commit other specified offenses with respect to Medicare or Medicaid claims; and (2) knowing creation or use of false records or statements with respect to the transmission of money or property to a federal health care program. Extends the statute of limitations from six to 10 years after presentation of a claim.
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Amends SSA title XI, as amended by the Patient Protection and Affordable Care Act, with respect to the access to claims and payment data granted to the Inspector General of the Department of Health and Human Services (HHS). Requires the Inspector General to implement mechanisms for the sharing of information about suspected fraud relating to the federal health care programs under Medicare, Medicaid, and SSA title XXI (Children's Health Insurance Program) (CHIP) with other appropriate law enforcement officials.
Directs the HHS Secretary to implement a five-year Beneficiary Verification Pilot Program to verify, with respect to Medicare claims, that the beneficiary for which the claim was made was actually furnished the claimed item or service.
Requires the Comptroller General to study and report to Congress on Medicare administrative contractors, including Recovery Audit Contractors.
People & committees
Sen. Gillibrand, Kirsten E. [D-NY] · D–NY
Legislative record
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Read twice and referred to the Committee on Finance.
Introduced in Senate
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Source last updated: Aug 14, 2025. Consult Congress.gov for the current record.
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