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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.
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.
Summary
This bill amends federal law to expand mandatory exclusion from federal health care programs for fraud-related offenses. The bill requires the Secretary of Health and Human Services to exclude individuals and entities convicted of fraud, theft, embezzlement, or financial misconduct related to health care items or services or government health programs. The bill also requires exclusion of individuals and entities the Secretary determines have committed fraud, kickbacks, or other prohibited activities under existing law. These mandatory exclusions apply to convictions and determinations made one year or more after the bill's enactment.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
- Rep. Pocan, Mark [D-WI-2] (D-WI)
17 cosponsors
- Del. Norton, Eleanor Holmes [D-DC-At Large] (D-DC)
- Rep. Bell, Wesley [D-MO-1] (D-MO)
- Rep. Carson, André [D-IN-7] (D-IN)
- Rep. Casar, Greg [D-TX-35] (D-TX)
- Rep. Cohen, Steve [D-TN-9] (D-TN)
- Rep. DeLauro, Rosa L. [D-CT-3] (D-CT)
- Rep. Dingell, Debbie [D-MI-6] (D-MI)
- Rep. Doggett, Lloyd [D-TX-37] (D-TX)
- Rep. Jayapal, Pramila [D-WA-7] (D-WA)
- Rep. Khanna, Ro [D-CA-17] (D-CA)
- Rep. Ocasio-Cortez, Alexandria [D-NY-14] (D-NY)
- Rep. Omar, Ilhan [D-MN-5] (D-MN)
- Rep. Pingree, Chellie [D-ME-1] (D-ME)
- Rep. Schakowsky, Janice D. [D-IL-9] (D-IL)
- Rep. Takano, Mark [D-CA-39] (D-CA)
- Rep. Thanedar, Shri [D-MI-13] (D-MI)
- Rep. Tlaib, Rashida [D-MI-12] (D-MI)
Actions (2)
- Nov 18, 2025 Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. · house
- Nov 18, 2025 Introduced in House
Similar bills (6)
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Text versions (1)
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Full text
IN THE HOUSE OF REPRESENTATIVES
November 18, 2025
Mr. Pocan (for himself, Mr. Carson, Mr. Cohen, Ms. DeLauro, Mr. Doggett, Ms. Jayapal, Mr. Khanna, Ms. Norton, Ms. Ocasio-Cortez, Ms. Schakowsky, Mr. Takano, Mr. Thanedar, Ms. Tlaib, Mr. Bell, and Ms. Omar) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
A BILL
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.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. MAKING CERTAIN EXCLUSIONS FROM PARTICIPATION IN FEDERAL HEALTH CARE PROGRAMS RELATED TO FRAUD MANDATORY.
(a) In General.—Section 1128 of the Social Security Act (42 U.S.C. 1320a-7) is amended—
(1) in subsection (a), by adding at the end the following new paragraphs:
“(5) Conviction relating to fraud.—Any individual or entity that has been convicted for an offense which occurred on or after the date that is 1 year after the date of the enactment of this paragraph, under Federal or State law—
“(A) of a criminal offense consisting of a misdemeanor relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct—
“(i) in connection with the delivery of a health care item or service, or
“(ii) with respect to any act or omission in a health care program (other than those specifically described in paragraph (1)) operated by or financed in whole or in part by any Federal, State, or local government agency; or
“(B) of a criminal offense relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct with respect to any act or omission in a program (other than a health care program) operated by or financed in whole or in part by any Federal, State, or local government agency.
“(6) Fraud, kickbacks, and other prohibited activities.— Any individual or entity that the Secretary determines has committed an act which is described in section 1128A, 1128B, or 1129 on or after the date that is 1 year after the date of the enactment of this paragraph.”;
(2) in subsection (b)—
(A) in paragraph (1), by inserting “and before the date that is 1 year after the date of the enactment of subsection (a)(5)” before “, under Federal or State law”; and
(B) in paragraph (7), by inserting “before the date that is 1 year after the date of the enactment of subsection (a)(6)” before the period at the end; and
(3) in subsection (f)(2), by inserting “(a)(6) or” after “subsection” each place it appears.
(b) Conforming Amendment.—Section 1128D(a)(1)(A)(ii) of the Social Security Act (42 U.S.C. 1320a-7d(a)(1)(A)(ii)) is amended by striking “section 1128(b)(7)” and inserting “subsection (a)(6) or (b)(7) of section 1128”. <all>
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