[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 3727 Introduced in Senate (IS)]
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119th CONGRESS
2d Session
S. 3727
To combat fraud in Federal programs, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
January 29, 2026
Ms. Ernst introduced the following bill; which was read twice and
referred to the Committee on Finance
_______________________________________________________________________
A BILL
To combat fraud in Federal programs, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Putting an N to Learing about Fraud
Act''.
SEC. 2. PREVENTING FRAUD IN CHILD CARE SERVICES.
(a) State Plan.--Section 658E of the Child Care and Development
Block Grant Act of 1990 (42 U.S.C. 9858c) is amended--
(1) in subsection (c)(2), by adding by striking
subparagraph (S) and inserting the following:
``(S) Attendance-based billing.--The plan shall
include an assurance that the lead agency will provide
payment under this subchapter to a child care provider
based on recorded attendance, rather than enrollment
alone, in the program of the provider.''; and
(2) by adding at the end the following:
``(e) Timing of Payment.--Nothing in this subchapter shall be
construed to require a lead agency to make a payment to a child care
provider prior to the provision of child care services. The lead agency
shall make a payment under this subchapter to such a provider as
reimbursement, in a timely manner, and on the basis of the provider's
provision of child care services.''.
(b) Audits.--Section 658K of the Child Care and Development Block
Grant Act of 1990 (42 U.S.C. 9858i) is amended by adding at the end the
following:
``(c) Federal Audits.--Each child care provider that receives a
payment under this subchapter shall prepare a record of attendance in
the provider's program and of the provider's provision of child care
services, and maintain the record for a period of 7 years after the
date of preparation of such record. The provider shall make such
records available for audits by the Secretary, the Attorney General,
and the Comptroller General of the United States.''.
SEC. 3. IDENTIFYING FRAUD IN HEALTH CARE SERVICES.
(a) Medicare.--
(1) In general.--The Secretary of Health and Human Services
shall, not later than 60 days after making a determination
described in paragraph (2), notify the Inspector General of the
Department of Health and Human Services of such determination.
(2) Determination.--A determination described in this
paragraph is a determination that--
(A) the aggregate amount paid under the Medicare
program under title XVIII of the Social Security Act
(42 U.S.C. 1395 et seq.) for an item or service or
items or services in a zip code and county or county
equivalent increased by more than 100 percent in a
single year; or
(B) the number of provider of services or suppliers
(as those terms are defined under section 1861 of the
Social Security Act (42 U.S.C. 1395x)) who received
payment for items or services furnished under the
Medicare program increased in a zip code and county or
county equivalent by more than 100 percent in a single
year.
(b) Qualified Health Plans Under the American Health Benefit
Exchanges.--
(1) In general.--The Secretary of Health and Human Services
shall, not later than 60 days after making a determination
described in paragraph (2), notify the Inspector General of the
Department of Health and Human Services of such determination.
(2) Determination.--A determination described in this
paragraph is a determination that--
(A) the aggregate amount paid under all qualified
health plans offered through the American Health
Benefit Exchanges established under sections 1311 and
1321 of the Patient Protection and Affordable Care Act
(42 U.S.C. 18031, 18041) for an item or service or
items or services in a zip code and county or county
equivalent increased by more than 100 percent in a
single year; or
(B) the number of providers of services who
received payment for items or services under such
qualified health plans increased in a zip code and
county or county equivalent by more than 100 percent in
a single year.
(3) Requirement to submit certain information.--Annually,
each American Health Benefit Exchange established under section
1311 or 1321 of the Patient Protection and Affordable Care Act
(42 U.S.C. 18031, 18041) shall collect from each qualified
health plan offered through such an Exchange, and submit to the
Secretary of Health and Human Services, the information
necessary for the Secretary to make a determination described
in paragraph (2).
(c) Medicaid and CHIP.--
(1) Medicaid.--Section 1902 of the Social Security Act (42
U.S.C. 1396a) is amended--
(A) in subsection (a)--
(i) in paragraph (88), by striking ``;
and'' and inserting a semicolon;
(ii) in paragraph (89), by striking the
period at the end and inserting ``; and''; and
(iii) by adding after paragraph (89) the
following new paragraph:
``(90) provide that, not later than 60 days after making a
determination described in subsection (yy), the State agency
shall notify the Secretary and the Inspector General of the
Department of Health and Human Services of such
determination.''; and
(B) by adding at the end the following new
subsection:
``(yy) Determination of Certain Increased Payments or Providers in
a Single Year.--For purposes of subsection (a)(90), a determination
described in this subsection is a determination that--
``(1) the aggregate amount paid under the State plan under
this title, or under a waiver of such plan, for an item or
service or items or services in a zip code and county or county
equivalent increased by more than 100 percent in a single year;
or
``(2) the number of providers of items or services who
received payments for items or services furnished in a zip code
and county or county equivalent under such State plan or waiver
increased by more than 100 percent in a single year.''.
(2) CHIP.--Section 2107(e)(1) of the Social Security Act
(42 U.S.C. 1397gg(e)(1)) is amended by--
(A) redesignating subparagraphs (I) through (W) as
subparagraphs (J) through (X), respectively; and
(B) inserting after subparagraph (H) the following
subparagraph:
``(I) Subsections (a)(90) and (yy) of section 1902
(relating to determination of certain increased
payments or providers in a single year and notification
to the Secretary and the Inspector General of Health
and Human Services).''.
(d) Audit by the Inspector General of Health and Human Services.--
Not later than 5 years after the date of enactment of this Act, and
annually thereafter, the Inspector General of Health and Human Services
shall--
(1) identify, based on the results of any notifications
received under subsection (a) or (b), or under section
1902(a)(90) of the Social Security Act (42 U.S.C. 1396a(a)(90))
or section 2107(e)(1)(I) of such Act (42 U.S.C.
1397gg(e)(1)(I)), any program or State plan or waiver (in the
case of Medicaid and the State Children's Health Insurance
Program) under which the aggregate amount paid for an item or
service or items or services in a zip code and county or county
equivalent or the number of providers of items or services or
suppliers, as applicable, who received payments for items or
services furnished in a zip code and county or county
equivalent increased by at least 400 percent during the
preceding 5-year period; and
(2) audit any such program, State plan, or waiver.
(e) Effective Date.--
(1) Medicare.--Subsection (a) shall take effect on the date
that is 180 days after the date of enactment of this Act.
(2) Qualified health plans under the american health
benefit exchanges.--Subsection (b) shall take effect on the
date that is 180 days after the date of enactment of this Act.
(3) Medicaid and chip.--
(A) In general.--Except as provided in subparagraph
(B), the amendments made by subsection (c) shall take
effect on the date that is 180 days after the date of
enactment of this Act.
(B) Delay permitted if state legislation
required.--In the case of a State plan approved under
title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.) or title XXI of such Act (42 U.S.C. 1397aa et
seq.) which the Secretary of Health and Human Services
determines requires State legislation (other than
legislation appropriating funds) in order for the plan
to meet the additional requirements imposed by the
amendments made by subsection (c), the State plan shall
not be regarded as failing to comply with the
requirements of such title XIX or XXI (as applicable)
solely on the basis of the failure of the plan to meet
such additional requirements before the first day of
the first calendar quarter beginning after the close of
the first regular session of the State legislature that
ends after the 1-year period beginning with the date of
the enactment of this section. For purposes of the
preceding sentence, in the case of a State that has a
2-year legislative session, each year of the session is
deemed to be a separate regular session of the State
legislature.
SEC. 4. RECOVERING IMPROPER PAYMENTS.
(a) Guidance.--The Director of the Office of Management and Budget
shall prescribe guidance to all agencies (as defined in section 551 of
title 5, United States Code) to ensure that all improper payments (as
defined in section 3351 of title 31, United States Code) are recovered.
(b) Annual Inspector General Report.--Section 3353(a)(1) of title
31, United States Code, is amended--
(1) in subparagraph (A), by striking ``and'' at the end;
(2) in subparagraph (B)(iv), by striking the period at the
end and inserting ``; and''; and
(3) by adding at the end the following:
``(C) include in each report submitted under
subparagraph (B) the amount of improper payments
recovered by the executive agency in the fiscal year
covered by the report.''.
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