Bill > HR2079

This bill aims to reduce fraudulent enrollments in qualified health plans (QHPs) by establishing new penalties and oversight mechanisms for insurance agents and brokers. The bill introduces civil and criminal penalties for agents and brokers who provide incorrect, false, or fraudulent information during health insurance enrollment, with fines ranging from $10,000 to $200,000 and potential imprisonment of up to 10 years for knowingly submitting fraudulent information. It mandates a new verification process for new enrollments and coverage changes submitted by agents or brokers, requiring documentation of individual consent, delaying commission payments until enrollment inconsistencies are resolved, and ensuring individuals can access and verify their account information. The bill also establishes new regulatory criteria for agents, brokers, field marketing organizations, and third-party marketing organizations, including a requirement to act in the best interests of enrollees, submit marketing materials for review, and meet specific marketing and licensing requirements. Additionally, the bill introduces a comprehensive audit process overseen by the Secretary of Health and Human Services, in coordination with states, to monitor and enforce compliance, including periodic audits based on complaints and potential fraud indicators, and the development of a regularly updated list of suspended and terminated agents and brokers.

Business and Industry

https://www.congress.gov/bill/119th-congress/house-bill/2079/all-info