The Insurance Fraud Accountability Act strengthens penalties and oversight for insurance agents and brokers who commit fraud or provide false information when helping people enroll in health insurance plans through the Affordable Care Act marketplaces. The bill imposes civil penalties of $10,000 to $50,000 per individual for negligent violations by agents or brokers, up to $200,000 per individual for knowing violations, and up to 10 years in prison for willful criminal violations. It also requires the federal government to establish an enrollment verification system by January 1, 2028, that includes obtaining consent documentation from individuals before enrollment, delaying commission payments until inconsistencies are resolved, and providing consumers with clear notifications and easy access to cancel unauthorized activity. The legislation adds new regulations for field marketing organizations and third-party marketing organizations involved in the enrollment process, requiring them to meet standards of conduct and submit marketing materials for review. Additionally, the bill mandates periodic audits of agents and brokers based on complaints and suspicious enrollment patterns, with results shared with state insurance departments to detect and prevent fraud.
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