To amend title XI of the Social Security Act to require the Secretary to exclude certain individuals and entities who commit fraud from participation in any Federal health care program.
Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.
Summary
What This Bill Does
Makes exclusion from federal health care programs mandatory for certain individuals and entities involved in fraud and related financial misconduct.
Who Benefits and How
Federal health care programs and beneficiaries could receive stronger protection against fraudulent or financially abusive actors.
Who Bears the Burden and How
Providers and entities found to have engaged in covered fraud or financial misconduct would face mandatory exclusion from federal health care programs.
Key Provisions
- Adds mandatory exclusion categories for certain misdemeanor fraud and other financial misconduct tied to health care or government programs.
- Adds mandatory exclusion for individuals or entities committing acts described in certain civil monetary penalty and anti-fraud provisions.
- Conforms related timing references in existing permissive exclusion provisions.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers.
At a Glance
What This Bill Does
Makes exclusion from federal health care programs mandatory for certain individuals and entities involved in fraud and related financial misconduct.
Key Policy Areas
Healthcare, Government Operations, Criminal Justice
Primary Purpose
Makes exclusion from federal health care programs mandatory for certain individuals and entities involved in fraud and related financial misconduct.
Policy Domains
Main Provisions
Identified Gains
Contextual inference, no direct clause citation- Federal health care programs and beneficiaries seeking stronger anti-fraud enforcement
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Individuals and entities subject to mandatory exclusion for fraud-related misconduct
Contextual inference, no direct clause citation
Sponsors
Legislative Progress
IntroducedMr. Pocan (for himself, Mr. Carson, Mr. Cohen, Ms. DeLauro, …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Individuals and entities subject to mandatory exclusion for fraud-related misconduct
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology