HR 173 - Medicare Fraud Prevention Act of 2011

HR 173

112th CONGRESS
1st Session

H. R. 173

To amend titles XI and XVIII of the Social Security Act to provide increased civil and criminal penalties for acts involving fraud and abuse under the Medicare Program and to increase the amount of the surety bond required for suppliers of durable medical equipment.

IN THE HOUSE OF REPRESENTATIVES

January 5, 2011

Mr. STEARNS introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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

A BILL

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Medicare Fraud Prevention Act of 2011'.

SEC. 2. INCREASED CIVIL MONEY PENALTIES AND CRIMINAL FINES FOR MEDICARE FRAUD AND ABUSE.

(a) Increased Civil Money Penalties- Section 1128A of the Social Security Act (42 U.S.C. 1320a-7a) is amended--

(1) in subsection (a), in the flush matter following paragraph (10)--

(A) by striking `$10,000' each place it appears and inserting `$20,000';

(B) by striking `$15,000' and inserting `$30,000'; and

[ Bracketed addition made 
        to account for amendments made by PPPACA PL111-148. Please review to be 
        sure that addition reflects policy intent. ]

(2) in subsection (b)--

(A) in paragraph (1), in the flush matter following subparagraph (B), by striking `$2,000' and inserting `$4,000';

(B) in paragraph (2), by striking `$2,000' and inserting `$4,000'; and

(b) Increased Criminal Fines- Section 1128B of the Social Security Act (42 U.S.C. 1320a-7b) is amended--

(1) in subsection (a), in the flush matter following paragraph (6)--

(A) by striking `$25,000' and inserting `$100,000'; and

(B) by striking `$10,000' and inserting `$20,000';

(2) in subsection (b)--

(A) in paragraph (1), in the flush matter following subparagraph (B), by striking `$25,000' and inserting `$100,000'; and

(B) in paragraph (2), in the flush matter following subparagraph (B), by striking `$25,000' and inserting `$100,000';

(3) in subsection (c), by striking `$25,000' and inserting `$100,000';

(4) in subsection (d), in the second flush matter following subparagraph (B), by striking `$25,000' and inserting `$100,000'; and

(5) in subsection (e), by striking `$2,000' and inserting `$4,000'.

(c) Effective Date- The amendments made by this section shall apply to civil money penalties and fines imposed for actions taken on or after the date of enactment of this Act.

SEC. 3. INCREASED SENTENCES FOR FELONIES INVOLVING MEDICARE FRAUD AND ABUSE.

(a) False Statements and Representations- Section 1128B(a) of the Social Security Act (42 U.S.C. 1320a-7b(a)) is amended, in clause (i) of the flush matter following paragraph (6), by striking `not more than five years' and inserting `not more than 10 years'.

(b) Anti-Kickback- Section 1128B(b) of the Social Security Act (42 U.S.C. 1320a-7b(b)) is amended--

(1) in paragraph (1), in the flush matter following subparagraph (B), by striking `not more than five years' and inserting `not more than 10 years'; and

(2) in paragraph (2), in the flush matter following subparagraph (B), by striking `not more than five years' and inserting `not more than 10 years'.

(c) False Statement or Representation With Respect to Conditions or Operations of Facilities- Section 1128B(c) of the Social Security Act (42 U.S.C. 1320a-7b(c)) is amended by striking `not more than five years' and inserting `not more than 10 years'.

(d) Excess Charges- Section 1128B(d) of the Social Security Act (42 U.S.C. 1320a-7b(d)) is amended, in the second flush matter following subparagraph (B), by striking `not more than five years' and inserting `not more than 10 years'.

(e) Effective Date- The amendments made by this section shall apply to criminal penalties imposed for actions taken on or after the date of enactment of this Act.

SEC. 4. INCREASED SURETY BOND REQUIREMENT FOR SUPPLIERS OF DME.

(a) In General- Section 1834(a)(16)(B) of the Social Security Act (42 U.S.C. 1395m(a)(16)(B)) is amended by striking `$50,000' and inserting `$500,000'.

(b) Effective Date- The amendment made by this section shall apply to the issuance (or renewal) of a provider number for a supplier of durable medical equipment on or after the date of enactment of this Act.

END