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H.R. 5258 103rd Congress House

Health Fraud and Abuse Act of 1994

Official title: To improve Federal enforcement against health care fraud and abuse.

Introduced: October 7, 1994 See on congress.gov
Health AuditingCrime and Law EnforcementCrime preventionCriminal investigation
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DamagesEconomics and Public FinanceFederal advisory bodiesFederal aid to law enforcement agenciesFinance and Financial SectorFines (Penalties)FraudGiftsGovernment Operations and PoliticsGovernment trust fundsGovernmental investigationsInspectors generalLawLicensesMedicaid fraudMedicare fraudProsecutionPublic assistance programsRevenue sharingSocial WelfareState laws
This bill died when the 103rd Congress ended
It never became law before the 103rd Congress (1993–1994) adjourned, and bills don't carry over to the next Congress. It would have to be reintroduced. You can still save it for reference, but it won't receive updates.
 Everywhere this bill has been 4 steps
Introduced
In committee
Reported out
Passed House
Passed Senate
To President
Became law
Oct 19, 1994
Referred to the Subcommittee on Legislation and National Security.
Oct 19, 1994
Referred to the Subcommittee on Human Resources and Intergovernmental Relations.
Oct 7, 1994
Referred to the House Committee on Government Operations.
Oct 7, 1994
Introduced in House
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 Latest action October 19, 1994

Referred to the Subcommittee on Legislation and National Security.

 Plain-English summary Congressional Research Service

Health Fraud and Abuse Act of 1994 - Directs the Inspector General (IG) of each of the Departments of Health and Human Services, Defense, Labor, and Veterans Affairs and the Office of Personnel Management to conduct audits, civil and criminal investigations, inspections, and evaluations relating to the prevention, detection, and control of health care fraud and abuse in violation of any Federal law, with exceptions.

Sets forth provisions regarding the powers of IGs.

Directs the IGs to: (1) jointly establish a program to prevent, detect, and control health care fraud and abuse which considers the activities of Federal, State, and local law enforcement agencies (LEAs), Federal and State agencies responsible for the licensing and certification of health care providers, and State agencies designated under this Act; (2) develop an annual investigative plan; and (3) regularly consult with each other, such LEAs, Federal and State agencies responsible for the licensing and certification of health care providers, and Health Care Fraud and Abuse Control Units.

Requires the Governor of each State to designate State agencies which conduct, supervise, and coordinate audits, civil and criminal investigations, inspections, and evaluations relating to such prevention, detection, and control. Authorizes each Governor to establish and maintain a State agency to act as a Health Care Fraud and Abuse Control Unit.

Requires that each Unit be a single identifiable entity of State government which is separate and distinct from any State agency with principal responsibility for the administration of health care programs and which meets specified requirements, such as being a unit of the State Attorney General or other State department that possesses statewide authority to prosecute individuals for criminal violations. Authorizes each Unit to submit each year to the IG a plan for preventing, detecting, and controlling health care fraud and abuse.

Sets forth provisions regarding: (1) IG approval of annual plans; (2) reporting requirements; (3) payments to States; and (4) data sharing.

Establishes: (1) within the Treasury the Health Care Fraud and Abuse Control Account; and (2) the Account Payments Advisory Board, which shall make recommendations to the IGs regarding the equitable allocation of payments from the Account.

 Related & companion bills 1
 Bill text 1 version

Source documents hosted by congress.gov.

 Committees of jurisdiction 3
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APA
U.S. Congress. (2026). H.R. 5258: Health Fraud and Abuse Act of 1994. 103rd Congress. Open America. https://openamerica.io/bill/103-HR-5258/
MLA
"H.R. 5258: Health Fraud and Abuse Act of 1994." 103rd Congress, 2026, Open America, https://openamerica.io/bill/103-HR-5258/.
Bluebook (legal)
H.R. 5258, 103rd Cong. (2026), https://openamerica.io/bill/103-HR-5258/.
Markdown link
[H.R. 5258: Health Fraud and Abuse Act of 1994](https://openamerica.io/bill/103-HR-5258/)
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