This Article examines the implications of the Affordable Care Act (ACA) on healthcare fraud-a problem that is responsible for roughly sixty billion dollars per year in Medicaid expenditures. By contextualizing the ACA’s changes within the purpose and policy goals of preexisting fraud law, this Article asserts that the ACA will lead to a “tighter, stricter, and more exacting” climate for healthcare providers. One example of such a change is the inclusion of new provider enrollment barriers-while these barriers make it more difficult for fraudulent providers to enter and exploit the Medicare billing system, they also impose a hardship on existing providers who must devote additional resources to preserve their billing privileges under the new enrollment architecture. The ACA also modifies the False Claims Act by lowering the evidentiary bar for qui tam relators, thereby improving the chances that the government will discover and prosecute parties who have made fraudulent claims. The ACA also modifies the Physician Self-Referral Law (or “Stark Law”) to require, among other things, that physicians provide patients with a list of alternative ancillary-service providers when requiring patients to undergo ancillary services such as diagnostic imaging. Finally, the Article argues that the Affordable Care Act equips the Anti-Kickback Statute with sharper teeth by altering the scienter requirement. The Article concludes that, although the ACA does not revolutionize preexisting fraud law, Congress clearly designed it to facilitate a new era of enforcement that aims to recover tens of billions of dollars from providers who commit fraud and to deter future instances of provider fraud.