S. 3384 — Fraud Risk Assessment of Obamacare Subsidies Accountability Act

This section directs the Secretary of Health and Human Services (HHS), in coordination with the Secretary of the Treasury, to prepare a fraud risk assessment of advance determinations under section 1412 of the Patient Protection and Affordable Care Act (42 U.S.C. 18082)—the program through which Exchanges request and receive advance eligibility determinations for premium tax credits under IRC §36B and cost-sharing reductions under ACA §1402, with advance payments made by Treasury to qualified health plan issuers—not later than December 31, 2025, and annually thereafter. Each assessment must include a complete list of HHS controls for preventing fraud in advance premium tax credit claims, be conducted in accordance with the July 2015 Government Accountability Office report titled “A Framework for Managing Fraud Risks in Federal Programs,” and be submitted to the HHS Inspector General and specified committees of Congress (Senate: Finance, Budget, and Health, Education, Labor, and Pensions; House: Ways and Means, Budget, and Energy and Commerce).