[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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