S. 976 · In committee · Health

Insurance Fraud Accountability Act

What it does

Imposes civil penalties of $10,000 to $50,000 per individual on agents and brokers who negligently provide incorrect enrollment information under the Affordable Care Act.
Imposes civil penalties up to $200,000 per individual on agents and brokers who knowingly provide false or fraudulent enrollment information.
Establishes criminal penalties of fines and imprisonment up to 10 years for agents and brokers who knowingly and willfully provide false or fraudulent enrollment information.
Requires the Secretary to establish an enrollment verification process for agent- or broker-assisted enrollments by January 1, 2029, including documentation of enrollee consent, delayed commission payment pending resolution of inconsistencies, and enrollee notification of coverage changes.
Requires agents, brokers, field marketing organizations, and third-party marketing organizations to meet minimum criteria including a fiduciary duty standard, state licensure, registration with the Secretary, and restrictions on referral compensation.

Nov 6, 2025: Committee on Homeland Security and Governmental Affairs Senate Permanent Subcommittee on Investigations. Hearings held.

Committee: Senate Permanent Subcommittee on Investigations