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2月9日（路透社）——医疗保险和医疗补助服务中心（CMS）周一提出多项法规，旨在打击医疗保险经纪人和代理人的欺诈及误导行为，以降低医疗成本。
该2027年付款通知为提供《平价医疗法案》（Affordable Care Act）医保计划的保险公司、经纪人和代理人设定了标准。
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“这项拟议规则将降低保费、扩大消费者选择权、打击欺诈行为，并推动优先考虑预防和长期健康的创新医保方案，”卫生部长小罗伯特·F·肯尼迪（Robert F. Kennedy Jr.）表示。
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该机构称，拟议规则鼓励以消费者为中心的新型医保计划设计，以扩大选择范围并支持医保可负担性。
CMS呼吁加强资格审查和收入验证，并强化执法政策，确保保费补贴仅用于符合条件的个人。
班加罗尔的斯妮哈·S·K（Sneha S K）报道；艾伦·巴罗纳（Alan Barona）和斯里拉伊·卡卢维拉（Sriraj Kalluvila）编辑
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US Medicare agency proposes rules to reduce health insurance fraud
February 9, 2026 10:07 PM UTC / Reuters
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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.
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“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.
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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
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