Strengthening Medicare Anti-Fraud Measures Act of 2011 - Amends title XI of the Social Security Act to authorize the Secretary of Health and Human Services (HHS) to exclude from participation in any federal health care program entities affiliated with a sanctioned entity, as well as any officer or managing employee of an affiliated entity (currently, only individuals with an ownership or control interest in a sanctioned entity), if the affiliated entity was so affiliated at the time of any of the conduct forming the basis for the conviction or exclusion of the sanctioned entity.
[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 675 Introduced in House (IH)]
112th CONGRESS
1st Session
H. R. 675
To amend title XI of the Social Security Act to expand the permissive
exclusion from participation in Federal health care programs to
individuals and entities affiliated with sanctioned entities.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 11, 2011
Mr. Herger (for himself, Mr. Stark, Mr. Nunes, Mr. Levin, Mr. Tiberi,
Mr. Rangel, Mr. Davis of Kentucky, Mr. McDermott, Mr. Reichert, Mr.
Lewis of Georgia, Mr. Boustany, Mr. Neal, Mr. Heller, Mr. Doggett, Mr.
Gerlach, Mr. Larson of Connecticut, Mr. Buchanan, Mr. Blumenauer, Mr.
Paulsen, Mr. Kind, and Mr. Pascrell) introduced the following bill;
which was referred to the Committee on Energy and Commerce, and in
addition to the Committees on Ways and Means and the Budget, 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 XI of the Social Security Act to expand the permissive
exclusion from participation in Federal health care programs to
individuals and entities affiliated with sanctioned entities.
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 ``Strengthening Medicare Anti-Fraud
Measures Act of 2011''.
SEC. 2. PERMISSIVE EXCLUSION FROM FEDERAL HEALTH CARE PROGRAMS EXPANDED
TO INDIVIDUALS AND ENTITIES AFFILIATED WITH SANCTIONED
ENTITIES.
Section 1128(b)(15) of the Social Security Act (42 U.S.C. 1320a-
7(b)(15)) is amended to read as follows:
``(15) Individuals or entities affiliated with a sanctioned
entity.--(A) Any of the following:
``(i) Any individual who--
``(I) is a person with an ownership or
control interest (as defined in section
1124(a)(3)) in a sanctioned entity or an
affiliated entity of such sanctioned entity (or
was a person with such an interest at the time
of any of the conduct that formed a basis for
the conviction or exclusion described in
subparagraph (B)); and
``(II) knows or should know (as defined in
section 1128A(i)(7)) (or knew or should have
known) of such conduct.
``(ii) Any individual who is an officer or managing
employee (as defined in section 1126(b)) of a
sanctioned entity or affiliated entity of such
sanctioned entity (or was such an officer or managing
employee at the time of any of the conduct that formed
a basis for the conviction or exclusion described in
subparagraph (B)).
``(iii) Any affiliated entity of a sanctioned
entity.
``(B) For purposes of this paragraph, the term `sanctioned
entity' means an entity--
``(i) that has been convicted of any offense
described in subsection (a) or in paragraph (1), (2),
or (3) of this subsection; or
``(ii) that has been excluded from participation
under a program under title XVIII or under a State
health care program.
``(C)(i) For purposes of this paragraph, the term
`affiliated entity' means, with respect to a sanctioned
entity--
``(I) an entity affiliated with such sanctioned
entity; and
``(II) an entity that was so affiliated at the time
of any of the conduct that formed the basis for the
conviction or exclusion described in subparagraph (B).
``(ii) For purposes of clause (i), an entity shall
be treated as affiliated with another entity if--
``(I) one of the entities is a person with
an ownership or control interest (as defined in
section 1124(a)(3)) in the other entity (or had
such an interest at the time of any of the
conduct that formed a basis for the conviction
or exclusion described in subparagraph (B));
``(II) there is a person with an ownership
or control interest (as defined in section
1124(a)(3)) in both entities (or had such an
interest at the time of any of the conduct that
formed a basis for the conviction or exclusion
described in subparagraph (B)); or
``(III) there is a person who is an officer
or managing employee (as defined in section
1126(b)) of both entities (or was such an
officer or managing employee at the time of any
of the conduct that formed a basis for the
conviction or exclusion described in
subparagraph (B)).''.
SEC. 3. BUDGETARY EFFECTS OF PAYGO LEGISLATION.
The budgetary effects of this Act, for the purpose of complying
with the Statutory Pay-As-You-Go Act of 2010, shall be determined by
reference to the latest statement titled ``Budgetary Effects of PAYGO
Legislation'' for this Act, submitted for printing in the Congressional
Record by the Chairman of the House Budget Committee, provided that
such statement has been submitted prior to the vote on passage.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and the Budget, 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.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and the Budget, 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.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and the Budget, 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.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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