# Insurance Fraud Accountability Act: What You Need to Know

This bill cracks down on insurance fraud in the health insurance marketplace by creating new penalties for insurance agents and brokers who provide false information when people sign up for coverage. The law targets dishonest practices in the enrollment process—situations where agents or brokers might lie about someone's income, family size, or other details to get them into a plan they don't qualify for or to earn commissions fraudulently.

The bill establishes three levels of punishment for agents and brokers who break the rules. If someone makes honest mistakes due to carelessness, they can face civil penalties between $10,000 and $50,000 per person affected. If they knowingly provide false information, the penalty jumps to up to $200,000 per person. And if they deliberately and willfully commit fraud, they can face criminal charges including up to 10 years in prison. These penalties are in addition to any other legal consequences they might face.

To protect consumers, the bill requires the government to set up a verification system for agent-assisted enrollments by January 2029. When an agent or broker signs someone up for coverage, they'll need to provide proof of the person's consent and documentation showing they actually want that coverage. Commissions won't be paid until any inconsistencies in the application are resolved. People will also get clear notifications about any changes to their coverage and will be able to see who their agent is and what plan they're in through a website or phone line. If someone signs up for coverage without their knowledge, they'll get instructions on how to cancel it.

The bill also gives the government authority to regulate marketing organizations that work with agents and brokers, requiring them to register, submit marketing materials for approval, and avoid misleading practices. The government will conduct audits based on consumer complaints and suspicious enrollment patterns, then share results with state insurance departments to catch fraud before it happens.