Insurance Fraud Accountability Act

This bill amends the Patient Protection and Affordable Care Act to reduce fraudulent enrollments in qualified health plans by increasing penalties for agents and brokers, establishing new enrollment verification processes, regulating marketing organizations, and increasing transparency and oversight.

Sec. 2, Reduction of fraudulent enrollment in qualified health plans: This section adds new civil penalties for agents or brokers who fail to provide correct information due to negligence or disregard of rules, with fines of not less than $10,000 and not more than $50,000 per individual affected. It also adds penalties for knowingly providing false or fraudulent information, with fines of not more than $200,000 per individual, and criminal penalties of up to 10 years imprisonment for knowing and willful false or fraudulent information. It requires the Secretary to establish a verification process for new enrollments and coverage changes submitted by agents or brokers in federally operated Exchanges, including documentation of consent, delayed commission payments until inconsistencies are resolved, notification of changes to individuals, and reporting of third-party marketing organizations. It also requires issuers to report terminations to the Secretary. It gives the Secretary authority to regulate field marketing organizations and third-party marketing organizations, requiring standards of conduct, reporting of agent terminations, marketing requirements, and registration. It mandates periodic audits of agents and brokers based on complaints, fraud patterns, and other factors, with results shared with states. It requires the Secretary to develop a list of suspended and terminated agents and brokers to be provided to qualified health plans, Exchanges, and states.