H.R. 10348 — Health Care Fraud Prevention and Enforcement Act

This section increases annual appropriations for the Health Care Fraud and Abuse Control Program to $490 million for HHS and Justice, $320 million for the HHS Inspector General, $230 million for the FBI, $1.28 billion for the Medicare Integrity Program, and $110 million for the Medicare-Medicaid data match program in FY2027, with stepped increases through FY2029 and CPI adjustments thereafter. It expands OIG authority to Affordable Care Act programs, clarifies that health plans include public and private plans, adds a rule of construction preserving authority to detect fraud and communicate with the public, and shifts the annual congressional report deadline to April 1.

This section directs the Comptroller General to study the performance and effectiveness of the Health Care Fraud and Abuse Control Program. The study must examine use of appropriations by HHS and DOJ, performance metrics, fund obligations, changes in outputs since the prior GAO report, evidence of reduced fraud and abuse, and timeliness of annual reports, with results and recommendations due to Congress within 16 months of enactment.