Protecting Seniors from Health Care Fraud Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to direct the Secretary of Health and Human Services (HHS), acting through the HHS Office of Inspector General, and the Attorney General to report annually to Congress and the public on health care fraud schemes targeted to seniors and steps being taken to combat such schemes and to educate seniors about them.
Directs the Secretary to: (1) disseminate such reports through mechanisms that reach the most Medicare beneficiaries, and (2) mail to each Medicare beneficiary a list of the top 10 most prevalent health care fraud schemes.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3616 Introduced in House (IH)]
113th CONGRESS
1st Session
H. R. 3616
To amend title XVIII of the Social Security Act to distribute
additional information to Medicare beneficiaries to prevent health care
fraud, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 21, 2013
Mr. Ruiz (for himself, Mr. Rooney, Mr. Mullin, Mr. Hanna, Mr. Nolan,
Mr. Murphy of Florida, Mrs. Negrete McLeod, Mr. Cartwright, Mr. Peters
of California, and Mr. Garcia) 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 XVIII of the Social Security Act to distribute
additional information to Medicare beneficiaries to prevent health care
fraud, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; FINDINGS.
(a) Short Title.--This Act may be cited as the ``Protecting Seniors
from Health Care Fraud Act of 2013''.
(b) Findings.--Congress finds the following:
(1) Seniors are more vulnerable to fraud than the general
population.
(2) Because seniors require more health care services than
the general population, they need more information on health
care schemes so they can protect themselves.
(3) The Department of Health and Human Services should
provide more up-to-date information in order to educate seniors
on health care scams.
SEC. 2. DISTRIBUTION OF ADDITIONAL INFORMATION TO SENIORS TO PREVENT
HEALTH CARE FRAUD.
Section 1804 of the Social Security Act (42 U.S.C. 1395b-2) is
amended by adding at the end the following new subsection:
``(d) Distribution of Additional Information on Health Care
Fraud.--
``(1) Annual reports on health care fraud schemes.--
``(A) In general.--In connection with the Health
Care Fraud and Abuse Control Program established under
section 1128C, the Secretary, acting through the Office
of the Inspector General of the Department of Health
and Human Services, and the Attorney General, shall
transmit to Congress, and make available to the public,
an annual report on health care fraud schemes that are
targeted to seniors and steps that are being taken to
combat such schemes and to educate seniors concerning
such schemes. The first such report shall be
transmitted and made available not later than 2 years
after the date of the enactment of this subsection.
``(B) Contents of reports.--
``(i) In general.--Subject to clause (ii),
each annual report under subparagraph (A) shall
include the following information:
``(I) Identification of most
prevalent fraud schemes.--The
identification of the 10 most prevalent
health care fraud schemes that are
targeted to seniors and the prevalence
and trends in such schemes.
``(II) Protection of seniors.--
Actions that seniors and law
enforcement and government agencies are
taking and can take to combat such
schemes and to protect seniors against
health care fraud schemes.
``(III) Additional suggestions.--
Policy suggestions to improve
protections for seniors, including
whether the additional information
provided under this subsection is
helping seniors in protecting them
against fraud.
``(ii) Limitations.--The Secretary may--
``(I) omit information from an
annual report on fraud schemes
targeting seniors if public disclosure
of the information would compromise an
ongoing investigation; and
``(II) report information on fraud
schemes by categories in an annual
report if a more detailed disclosure of
such a scheme would educate criminals
rather than seniors.
``(iii) Private-public partnership.--The
Secretary, acting through the Office of the
Inspector General of the Department of Health
and Human Services and the Attorney General,
may enter into an arrangement between public
and private partners to develop the report that
identifies the top 10 most prevalent health
care fraud schemes and the associated report
information.
``(C) Quarterly updating.--The information
described in clauses (i) and (ii) of subparagraph (B)
shall be updated quarterly to reflect changes in fraud
schemes and methods to combat and educate seniors
concerning such schemes.
``(D) Languages.--Such reports, as updated, shall
be available in English and Spanish.
``(2) Dissemination of reports and top 10 list.--
``(A) In general.--The Secretary shall--
``(i) disseminate the reports under
paragraph (1) to Medicare beneficiaries through
mechanisms that reach the most Medicare
beneficiaries; and
``(ii) provide for the mailing to each
Medicare beneficiary of a list of the top 10
most prevalent health care fraud schemes.
``(B) Quarterly updates of top 10 list included
with medicare summary notices.--The Secretary shall
include an updated list of the top 10 most prevalent
health care fraud schemes under paragraph (1)(C) with
the quarterly Medicare summary notices mailed to
Medicare beneficiaries.
``(C) Posting of reports and quarterly updates on
websites.--The annual reports, and quarterly updates,
under this subsection shall be posted on the website of
the Health Care Fraud and Abuse Control Program and on
other websites maintained or supported by the Secretary
relating to the Medicare program, the State Health
Insurance Assistance Program, and Senior Medicare
Patrol of the Administration on Aging.
``(3) Sources of information for reports.--Information for
the reports and updates under paragraph (1) shall be gathered
from at least the following sources:
``(A) Department of health and human services.--The
following sources within the Department of Health and
Human Services:
``(i) Medicare hotlines, including 1-800-
MEDICARE, 1-800-HHSTIPS, and Medicare fraud
toll-free hotlines and websites (such as
www.stopmedicarefraud.gov) established by the
Office of the Inspector General of the
Department of Health and Human Services and the
Centers for Medicare & Medicaid Services.
``(ii) State Health Insurance Assistance
Programs (SHIPs).
``(iii) The Administration on Community
Living, including--
``(I) the Senior Medicare Patrol
(SMP) of the Administration on Aging;
and
``(II) Aging and Disability
Resource Centers.
``(iv) Medicare administrative contractors,
fiscal intermediaries, and other contractors
with the Centers for Medicare & Medicaid
Services performing functions which may relate
to fraud and abuse under the Medicare program.
``(v) The Indian Health Service.
``(B) Department of justice.--The Department of
Justice, including the Federal Bureau of Investigation.
``(C) SSA.--The Social Security Administration.
``(D) FTC.--The Federal Trade Commission.
``(E) Optional additional sources.--At the option
of the Secretary--
``(i) State agencies that deal with elder
abuse; and
``(ii) other governmental and
nongovernmental entities with expertise in the
protection of seniors from health care fraud as
deemed appropriate.''.
<all>
Introduced in House
Introduced in House
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.
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.
Referred to the Subcommittee on Health.
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