Health Care Fraud Prevention and Enforcement Act

S. 5326 — Health Care Fraud Prevention and Enforcement Act would amend Medicare law to reauthorize and increase funding for the Health Care Fraud and Abuse Control Program through fiscal year 2029, with automatic inflation-based increases in later years. It raises appropriations caps for HHS, the Department of Justice, the HHS Inspector General's office, the FBI, the Medicare Integrity Program, and the Medicare-Medicaid Data Match Program. It also expands the HHS Inspector General's investigative authority to cover programs created under the Affordable Care Act, clarifies that "health plan" fraud-control provisions apply to both public and private plans, and extends the Medicare-Medicaid Data Match Program to include the Children's Health Insurance Program starting in 2027.

The bill primarily affects federal agencies responsible for detecting and prosecuting health care fraud—HHS, DOJ, the FBI, and the HHS Inspector General—by giving them more funding and, in some cases, broader authority. It also changes reporting requirements, moving the annual fraud-control report deadline from January 1 to April 1 and requiring agencies to notify Congress if that report is delayed.

The bill was introduced in the Senate on August 6, 2026, by Sen. Cortez Masto with several cosponsors, read twice, and referred to the Senate Finance Committee. It also directs the Government Accountability Office to study the program's performance and report to Congress within 16 months. Next steps would include committee consideration before any floor vote.

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