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US Medicare agency proposes rules to reduce health insurance fraud

By Thomson Reuters Feb 9, 2026 | 4:08 PM

Feb 9 (Reuters) – The Centers for Medicare & Medicaid Services on Monday proposed ‍regulations to crack down on fraud and misleading practices by health insurance agents and brokers to lower healthcare ‌costs.

The 2027 Payment Notice ‌sets standards for health insurance issuers, brokers and agents who offer Affordable Care Act coverage.

“This ​proposed rule lowers premiums, expands consumer choice, cracks ‍down on ​fraud, and promotes innovative ​coverage that prioritizes prevention and ‍long-term health,” said Health Secretary Robert F. Kennedy Jr.

The proposed rule encourages new, consumer-focused plan designs ‍that expand choice and support affordability, the agency said.

CMS has called ‍for ‍stronger eligibility and ​income verification, along with ​enhanced ⁠enforcement policies, to ensure ‌premium subsidies are reserved for eligible individuals.

(Reporting by Sneha S K in Bengaluru; Editing by Alan Barona and ⁠Sriraj Kalluvila)