Pennsylvania Senate Committee Passes Bill to Tackle Pennie Health Insurance Fraud

Pennsylvania's Senate Banking and Insurance Committee has advanced legislation targeting fraudulent enrolment on Pennie, the state's health insurance marketplace. Insurers have paid roughly $30m in fraudulent claims since October 2024.

Pennsylvania lawmakers move to curb $163m Pennie fraud crisis

Pennsylvania's Senate Banking and Insurance Committee has advanced a bill targeting fraudulent enrolment on Pennie, the state's health insurance marketplace, pasenategop.com reports. Committee chair Sen. Chris Gebhard (R-48) confirmed the move, which follows evidence that insurers offering plans through Pennie paid approximately $30 million in fraudulent claims since October 2024 — with more than $163.6 million in fraudulent claims billed to insurers in this calendar year alone.

Senate Bill 1439, sponsored by Sen. Tracy Pennycuick (R-24), would require applicants to submit proof of residency or documentation demonstrating their intent to reside in Pennsylvania. The legislation, formally titled the Reducing Fraudulent Pennie Claims Act, would also establish a dedicated Office of Fraud Prevention within Pennie to identify and counter fraudulent activity on the exchange.

"The amount of fraud identified within Pennie is troubling and highlights the need for greater safeguards and accountability," Gebhard said. He noted that health insurance premiums on Pennie rose by more than 14%, and criticised the absence of dedicated anti-fraud staff prior to this year: "For too long, this administration allowed fraud to continue unfettered, and that failure ultimately helped to make healthcare even less affordable for Pennsylvanians."

Pennycuick argued that strong oversight measures protect rather than restrict access to benefits. "Tackling fraud in our health insurance marketplace is critical to protecting consumers and the taxpayers who pay for subsidised healthcare," she said. "Strong safeguards are not barriers to access — they are essential protections that ensure benefits are available for eligible Pennsylvanians while preserving the integrity and long-term sustainability of the program."

Enrollment fraud has affected both federal and state Affordable Care Act exchanges across the country, with Pennie among those impacted. The bill mirrors language already adopted by the Pennsylvania House of Representatives on 9 June and carries bipartisan support. The measure now proceeds to the full Senate for further consideration.

Source: Google News MT — Crime (en)