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HR 5732 113th Congress House

Stop Schemes and Crimes Against Medicare and Seniors (Stop SCAMS) Act

Official title: To amend title XVIII of the Social Security Act to crack down on fraud in the Medicare program to protect seniors, people with disabilities, and taxpayers.

Introduced: November 18, 2014 See on congress.gov
Health Administrative law and regulatory proceduresCivil actions and liabilityCriminal justice information and recordsDepartment of Health and Human Services
More subjectsShow fewer subjects
Fraud offenses and financial crimesGovernment studies and investigationsHealth care costs and insuranceHealth information and medical recordsInsurance industry and regulationMedicarePublic-private cooperation
This bill died when the 113th Congress ended
It never became law before the 113th Congress (2013–2014) 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 3 steps
Introduced
In committee
Reported out
Passed House
Passed Senate
To President
Became law
Nov 21, 2014
Referred to the Subcommittee on Health.
Nov 18, 2014
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Nov 18, 2014
Introduced in House
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 Latest action November 21, 2014

Referred to the Subcommittee on Health.

 Plain-English summary Congressional Research Service

Stop Schemes and Crimes Against Medicare and Seniors (Stop SCAMS) Act - Amends title XI of the Social Security Act with respect to standards for financial and administrative transactions and their data elements to enable the electronic exchange of health information.

Requires the Secretary of Health and Human Services (HHS) to adopt standards that: (1) ensure that any entity producing and transmitting valid transactions that include code sets for appropriate data elements is subject to a consistent, industry-wide framework that supports a seamless transition to new and modified code sets; and (2) establish an end-to-end testing procedure for new and modified code sets that shall require the participation of any entity producing and transmitting valid transactions that use the new or modified code set.

Prohibits the Secretary from adopting a new or modified code set unless the Secretary: (1) assesses its impact on fraud prevention and pre-payment review, determines that anti-fraud edits work as intended, and confirms that a plan is in place to ensure continuing effective detection of fraud following the adoption of the code set; (2) ensures that the end-to-end testing procedure established has been completed; and (3) completes end-to-end testing with any federal government entity that produces and transmits valid transactions that include the code set with private sector tracking partners. Exempts routine, regularly scheduled updates to existing code sets from such prohibition.

Directs the Secretary, with respect to information supplied to it by a disclosing entity about those with an ownership or control interest in the entity, to verify such information in a specified manner and confirm the accuracy of any Social Security account number or employer identification number.

Holds immune from civil liability (in a safe harbor) any non-governmental entity participating in a Healthcare Fraud Prevention Partnership, including private insurers, for sharing information about potentially fraudulent providers with each other, HHS, the Department of Justice (DOJ), any other federal or state law enforcement agency, any federal or state agency contractor, and another Partnership participant.

Directs the Medicare Payment Advisory Commission (MEDPAC) to study administrative efforts to strengthen program integrity in the Medicare program.

Amends the Small Business Jobs Act of 2010, with respect to the use of predictive modeling and other analytics technologies to identify and prevent waste, fraud, and abuse in the Medicare fee-for-service program, to require predictive analytics technologies to capture outcome information on civil recoveries, administrative actions, and criminal convictions for fraud.

 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. 5732: Stop Schemes and Crimes Against Medicare and Seniors (Stop SCAMS) Act. 113th Congress. Open America. https://openamerica.io/bill/113-HR-5732/
MLA
"H.R. 5732: Stop Schemes and Crimes Against Medicare and Seniors (Stop SCAMS) Act." 113th Congress, 2026, Open America, https://openamerica.io/bill/113-HR-5732/.
Bluebook (legal)
H.R. 5732, 113th Cong. (2026), https://openamerica.io/bill/113-HR-5732/.
Markdown link
[H.R. 5732: Stop Schemes and Crimes Against Medicare and Seniors (Stop SCAMS) Act](https://openamerica.io/bill/113-HR-5732/)
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