Medicare Anti-Fraud Amendments of 1997

Medicare Anti-Fraud Amendments of 1997 - Amends title XVIII (Medicare) of the Social Security Act to: (1) prohibit the Secretary of Health and Human Services from issuing or renewing the provider number of a durable medical equipment supplier unless the supplier provides information on ownership or control interests and a surety bond of up to $50,000; (2) require home health agencies to provide such a surety bond; and (3) authorize application of such disclosure and surety bond requirements to suppliers of ambulance services and clinics that furnish medical and other health services (other than physicians' services) under Medicare part B (Supplementary Medical Insurance).

[Congressional Bills 105th Congress]
[From the U.S. Government Printing Office]
[H.R. 1457 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 1457

 To amend title XVIII of the Social Security Act to improve efforts to 
  combat fraud and abuse under the Medicare program for suppliers of 
 durable medical equipment, home health agencies, and other providers 
     through disclosure of information on ownership interests and 
                     requirement for a surety bond.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 24, 1997

   Mrs. Thurman (for herself, Mr. Stark, Mr. Shaw, and Mr. Davis of 
   Florida) introduced the following bill; which was referred to the 
  Committee on Commerce, 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

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to improve efforts to 
  combat fraud and abuse under the Medicare program for suppliers of 
 durable medical equipment, home health agencies, and other providers 
     through disclosure of information on ownership interests and 
                     requirement for a surety bond.

    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 Anti-Fraud Amendments of 
1997''.

SEC. 2. ANTI-FRAUD PROVISIONS.

    (a) Disclosure of Information and Surety Bond Requirement for 
Suppliers of Durable Medical Equipment.--Section 1834(a) of the Social 
Security Act (42 U.S.C. 1395m(a)) is amended by inserting after 
paragraph (15) the following new paragraph:
    ``(16) The Secretary shall not provide for the issuance (or 
renewal) of a provider number for a supplier of durable medical 
equipment, for purposes of payment under this part for durable medical 
equipment furnished by the supplier, unless the supplier provides the 
Secretary on a continuing basis with--
            ``(A)(i) full and complete information as to the identity 
        of each person with an ownership or control interest (as 
        defined in section 1124(a)(3)) in the supplier or in any 
        subcontractor (as defined by the Secretary in regulations) in 
        which the supplier directly or indirectly has a 5 percent or 
        more ownership interest, and
            ``(ii) to the extent determined to be feasible under 
        regulations of the Secretary, the name of any disclosing entity 
        (as defined in section 1124(a)(2)) with respect to which a 
        person with such an ownership or control interest in the 
        supplier is a person with such an ownership or control interest 
        in the disclosing entity; and
            ``(B) a surety bond in a form specified by the Secretary 
        and in an amount that is not less than $50,000.''.
    (b) Surety Bond Requirement for Home Health Agencies.--
            (1) In general.--Section 1861(o)(7) of such Act (42 U.S.C. 
        1395x(o)(7)) is amended by inserting ``and including providing 
        the Secretary on a continuing basis with a surety bond in a 
        form specified by the Secretary and in an amount that is not 
        less than $50,000'' after ``financial security of the 
        program''.
            (2) Conforming amendments.--Section 1861(v)(1)(H) of such 
        Act (42 U.S.C. 1395x(v)(1)(H)) is amended by striking ``the 
        financial security requirement'' and inserting ``the financial 
        security and surety bond requirements'' each place it appears 
        in clauses (i) and (ii).
            (3) Reference to current disclosure requirement.--For 
        provision of current law requiring home health agencies to 
        disclose information on ownership and control interests, see 
        section 1124 of the Social Security Act.
    (c) Authorizing Application of Disclosure and Surety Bond 
Requirements to Ambulance Services and Certain Clinics.--Section 
1834(a)(16) of the Social Security Act (42 U.S.C. 1395m(a)(16)), as 
added by subsection (a), is amended by adding at the end the following: 
``The Secretary, in the Secretary's discretion, may impose the 
requirements of the previous sentence with respect to some or all 
classes of suppliers of ambulance services described in section 
1861(s)(7) and clinics that furnish medical and other health services 
(other than physicians' services) under this part.''.
    (d) Effective Dates.--(1) The amendment made by subsection (a) 
shall apply to suppliers of durable medical equipment with respect to 
such equipment furnished on or after January 1, 1998.
    (2) The amendments made by subsection (b) shall apply to home 
health agencies with respect to services furnished on or after such 
date. The Secretary of Health and Human Services shall modify 
participation agreements under section 1866(a)(1) of the Social 
Security Act with respect to home health agencies to provide for 
implementation of such amendments on a timely basis.
    (3) The amendment made by subsection (c) shall take effect on the 
date of the enactment of this Act and may be applied with respect to 
items and services furnished on or after the date specified in 
paragraph (1).
                                 <all>