PIIA Reform Act
Key claim: HR1533 would create a federal ‘Overpayment Czar’ within OMB, require agencies to flag new high-outlay programs as susceptible to improper payments, and penalize noncompliant agencies by reducing their appropriations.
Abstract
(HR1533 · 119th Congress) PIIA Reform Act This bill establishes a federal Overpayment Czar position, requires federal agencies to identify certain programs and activities as susceptible to improper payments (i.e., payments that should not have been made or were made in an incorrect amount), and imposes financial penalties on agencies for noncompliance with requirements related to reducing improper payments. The bill establishes the position of Director of Improper Payment Mitigation, to be known as the Overpayment Czar, within the Office of Management and Budget (OMB). The duties of the Overpayment Czar include assisting federal agencies in preventing improper payments and fraud. Under the bill, federal agencies must additionally identify as susceptible to significant improper payments any program or activity that is in the first four years of operation and has or is expected to have outlays exceeding $100 million in any of the first three fiscal years of operation unless, based upon a review of the program or activity, the agency makes a determination to the contrary. The bill requires a reduction in certain appropriations accounts for agencies that do not comply with various requirements related to reducing improper payments (such as publishing improper payments estimates and programmatic corrective action plans). States receiving funding for certain programs, such as Medicaid and unemployment compensation, must use payment integrity tools approved by OMB to reduce overpayments. Each annual governmentwide five-year financial management plan produced by OMB must include a plan to decrease improper payments throughout executive agencies. Latest action (2025-02-24): Referred to the Committee on Oversight and Government Reform, 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.
Why this matters
Medicare and Medicaid together account for a large share of federal improper payments each year, so cross-government payment-integrity reforms translate directly into new CMS reporting, audit, and remediation obligations. Penalizing agencies via appropriations cuts could pressure HHS to tighten Medicaid eligibility verification, provider screening, and managed care oversight, with downstream effects on state administration and provider payment workflows.