S. 2128: Prevent Health Care Fraud Act of 2009
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S. 2128: Prevent Health Care Fraud Act of 2009
111th Congress · introduced 2009-10-29 · Health · Latest: Sponsor introductory remarks on measure. (CR S10949-10951)
federal
Follow this bill, step by step
- Where it came from: introduced 2009-10-29 · official record
- Who proposed it: Sen. LeMieux, George S. [R-FL] · what a sponsor is
- What happened next: no floor votes in our records yet. Why?
- Where it stands now: Sponsor introductory remarks on measure. (CR S10949-10951) Not final yet: this can still change. We check for updates every day.
- If it becomes law and spends money: follow the money to money laws, then agencies and contracts and grants.
Official title
Prevent Health Care Fraud Act of 2009
Plain summary
Prevent Health Care Fraud Act of 2009 - Establishes in the Department of Health and Human Services (HHS) the Office of the Deputy Secretary for Health Care Fraud Prevention. Requires the Office to: (1) direct the implementation within HHS of health care fraud prevention and detection recommendations made by federal and private sector antifraud and oversight entities; (2) routinely consult with HHS's Office of the Inspector General, the Attorney General, and private sector health care antifraud entities to identify emerging fraud issues requiring immediate action; (3) provide for the design, development, and operation of a predictive model antifraud system to analyze health care claims data in real-time to identify high risk claims activity and develop a comprehensive antifraud database for federal health agency activities; (4) promulgate and enforce regulations relating to the reporting of data claims to such system by federal health agencies; (5) establish thresholds for fraudulent, wasteful, or abusive claims for excluding providers or suppliers from participation in federal health programs and for the referral of claims to law enforcement entities; and (6) share antifraud information and best practices. Sets forth requirements for the fraud prevention system, including that it shall: (1) allow viewing of all provider and patient activities across all federal health program payers; (2) provide for a centralized file for data from all government health insurance claims data sources; (3) provide real-time ability to identify high-risk behavior patterns across markets, geographies, and specialty group providers; (4) involve the implementation of a predictive modeling technology that is designed to prevent waste, fraud, and abuse; (5) systematically present scores, reason codes, and treatment actions for high-risk scored transactions; (6) monitor consumer transactions in real-time and monitor provider behavior at different stages within the transaction flow based upon provider, transaction, and consumer trends; and (7) not be designed to deny health care services or to negatively impact prompt-pay laws because assessments are late. Directs the Deputy Secretary to: (1) prohibit the payment of any health care claim identified as potentially fraudulent, wasteful, or abusive until the claim has been verified as valid; and (2) provide maximum protection of personal privacy consistent with carrying out the Office's responsibilities. Directs the Secretary to establish procedures for the implementation of fraud and abuse detection methods under all federal health programs.
Congressional Research Service summary (Introduced in Senate), quoted unchanged (nonpartisan). Read the source.
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What does this mean? (plain words)
Official text
Prevent Health Care Fraud Act of 2009
Source: Congressional Research Service summary (Introduced in Senate)
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Alternatives
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How did my representative vote? · This bill's floor votes
Officials and money
Sponsor: Sen. LeMieux, George S. [R-FL] · 15 cosponsors
Cost estimate: No cost estimate published yet.
Cosponsors on this site
John Barrasso (R-WY), James E. Risch (R-ID), Sheldon Whitehouse (D-RI)
No linked floor roll calls in our collected records yet. This does not mean the bill has never had a vote. Check the official bill history.
Words on this page, explained (1)
- Rulemaking
- The process agencies use to write regulations that carry out laws passed by Congress or a legislature. Usually an agency publishes a proposed rule, takes public comments, then publishes a final rule.
Plain meanings written from linked sources. All words.
Sources
- Congressional Research Service summary (Introduced in Senate)
- Congress.gov
- Data: GovInfo BILLSTATUS bulk data (Library of Congress), BILLSTATUS-111s2128.xml <https://www.govinfo.gov/bulkdata/BILLSTATUS/111/s>
Record fed-us-cong111-s2128 · catalog fed-us-congress-bills-cong111 · updated 2026-11-15 by psicol fed-bills-cong111