Stark Administrative Simplification Act - Amends title XVIII (Medicare) of the Social Security Act (SSA) to prescribe a single civil monetary penalty as an alternative sanction to those already established for compensation arrangements between a physician (or an immediate family member) and a person or entity that is in violation of the limitation on certain physician referrals (Stark Law) solely due to technical noncompliance.
(The Stark law, or Stark Rule, prohibits physician referrals of certain health services for Medicare and Medicaid patients to a specified entity if the physician, or an immediate family member, has a financial relationship with that entity.)
Requires the Secretary of Health and Human Services (HHS) to accept the voluntary disclosure of a technically noncomplaint compensation arrangement by a person or entity in violation of the Stark Law under certain circumstances.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3776 Introduced in House (IH)]
113th CONGRESS
1st Session
H. R. 3776
To amend title XVIII of the Social Security Act to create alternative
sanctions for technical noncompliance with the Stark rule under
Medicare, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 16, 2013
Mr. Boustany (for himself, Mr. Kind, Mr. Bucshon, and Mr. Veasey)
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 create alternative
sanctions for technical noncompliance with the Stark rule under
Medicare, 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.
This Act may be cited as the ``Stark Administrative Simplification
Act''.
SEC. 2. ALTERNATIVE SANCTIONS FOR TECHNICAL NONCOMPLIANCE WITH STARK
RULE UNDER MEDICARE.
Section 1877(g) of the Social Security Act (42 U.S.C. 1395nn(g)) is
amended--
(1) in paragraph (1), by striking ``No'' and inserting
``Subject to paragraph (7), no'';
(2) in paragraph (2), by striking ``If'' and inserting
``Subject to paragraph (7), if'';
(3) in paragraph (3), by striking ``Any'' and inserting
``Subject to paragraph (7), any''; and
(4) by adding at the end the following new paragraph:
``(7) Alternative sanctions for technical noncompliance.--
``(A) Single penalty for compensation arrangements
in technical noncompliance.--In the case of a
compensation arrangement between a physician (or an
immediate family member of such physician) and a person
or entity that is in violation of subsection (a)(1)
solely due to technical noncompliance, instead of the
sanctions described in paragraphs (1), (2), and (3) for
any such violation, the person or entity with respect
to such arrangement shall be subject to a single civil
monetary penalty under this paragraph in an amount that
does not exceed--
``(i) in the case where the disclosure of
the violation is submitted to the Secretary not
later than the date that is one year after the
initial date of noncompliance, $5,000; and
``(ii) in the case where the disclosure of
the violation is submitted to the Secretary
after the date that is one year after the
initial date of noncompliance, $10,000.
``(B) Acceptance of voluntary disclosures.--
``(i) In general.--Effective on the date of
the enactment of this paragraph, the Secretary
shall accept the voluntary disclosure of a
technically noncompliant compensation
arrangement if such voluntary disclosure is
made as described in clause (iii). The
Secretary may accept and reasonably rely on
information provided by a person or entity that
is in violation of subsection (a)(1) only
because of a compensation arrangement that is
technically noncompliant.
``(ii) Acceptance of disclosure.--The
Secretary may reject any voluntary disclosure
submitted under clause (iii) within 90 days
after the receipt of the disclosure only if the
Secretary determines that the disclosure does
not conform to the requirements described in
clause (iii). If the Secretary fails to reject
a voluntary disclosure within such 90-day
period, the voluntary disclosure is deemed to
be accepted.
``(iii) Voluntary disclosure.--A voluntary
disclosure described in this clause, with
respect to a compensation arrangement, is a
disclosure submitted to the Secretary, by a
party to such arrangement that contains the
following:
``(I) The identification of the
disclosing party and all other parties
to the disclosed compensation
arrangement.
``(II) A description of the
compensation paid under the arrangement
and the dates of noncompliance.
``(III) A certification by the
disclosing party that the compensation
arrangement--
``(aa) is technically
noncompliant (as defined by
subparagraph (C));
``(bb) has been cured of
the technical noncompliance, or
is otherwise terminated; and
``(cc) is, in the case of
technical noncompliance under
subparagraph (C)(i), a valid
contract under State law, an
arrangement consistent with
fair market value, and one in
which remuneration under the
arrangement is not determined
in a manner that takes into
account directly or indirectly
the volume or value of any
referrals.
``(IV) Payment for the full amount
of the civil monetary penalty under
clause (i) or (ii), as applicable, of
subparagraph (A).
``(C) Definition technical noncompliance.--For
purposes of this paragraph, the term `technical
noncompliance' means an arrangement that is in
violation of subsection (a)(1) only because--
``(i) the arrangement is not set forth in
writing;
``(ii) the arrangement is not signed by 1
or more parties to the arrangement; or
``(iii) a prior arrangement expired and
services continued without the execution of an
amendment to such arrangement or a new
arrangement.
``(D) Applicability to pre-enactment disclosures to
relieve backlog.--The Secretary shall provide for the
application of this paragraph to any technically
noncompliant compensation arrangement that has been
disclosed, and to which there has not been a final
settlement as of the date of enactment of this
paragraph.
``(E) Report.--Not later than 24 months after the
date of enactment of this paragraph, the Inspector
General of the Department of Health and Human Services
shall submit to Congress a report on the implementation
of this paragraph. Such report shall include--
``(i) the number of persons or entities
making disclosures of technical noncompliance
under this paragraph;
``(ii) the amount and type of alternative
sanctions collected or imposed for technical
noncompliance;
``(iii) the types of violations disclosed;
and
``(iv) such other information as the
Inspector General determines may be necessary
to evaluate the impact of this paragraph.''.
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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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