Strengthening Medicare Anti-Fraud Measures Act of 2013

Strengthening Medicare Anti-Fraud Measures Act of 2013 - 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 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2925 Introduced in House (IH)]

113th CONGRESS
  1st Session
                                H. R. 2925

 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

                             August 1, 2013

   Mr. Brady of Texas (for himself, Mr. McDermott, Mr. Buchanan, Mr. 
      Gerlach, Mr. Kind, Mr. Levin, Mr. Blumenauer, Mr. Larson of 
 Connecticut, Mrs. Black, Mr. Doggett, Mr. Kelly of Pennsylvania, Mr. 
 Boustany, Mr. Lewis, Mr. Nunes, Mr. Griffin of Arkansas, Mr. Smith of 
Nebraska, Mr. Schock, Mr. Reichert, Mr. Sam Johnson of Texas, Mr. Reed, 
   Mr. Paulsen, Ms. Jenkins, Mr. Renacci, Mr. Lipinski, and Mr. Van 
   Hollen) introduced the following bill; which was referred to the 
 Committee on Energy and 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 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 2013''.

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)).''.
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