Stark Administrative Simplification Act of 2017
This bill establishes lesser penalties for technical noncompliance with the Stark Rule against self-referral under Medicare. "Technical noncompliance" means, with respect to a compensation arrangement, that the arrangement: (1) is not set forth in writing, (2) is not signed by one or more parties, or (3) violates the rule due to the arrangement's expiration.
[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3173 Introduced in House (IH)]
<DOC>
115th CONGRESS
1st Session
H. R. 3173
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
July 10, 2017
Mr. Marchant (for himself, Mr. Kind, and Mr. Meehan) 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 of 2017''.
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 in which 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 in which 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.--Beginning as of 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 is a
disclosure concerning a compensation
arrangement that is 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 satisfies the requirements
described in clause (v).
``(IV) Payment for the full amount
of the civil monetary penalty under
clause (i) or (ii), as applicable, of
subparagraph (A).
``(iv) Settlement of liability and payment
of claims.--A voluntary disclosure of a
technically noncompliant compensation
arrangement that is made and accepted under
this subparagraph shall constitute a full and
complete settlement of liability under this
subsection to the extent such liability is with
respect to such technically noncompliant
compensation arrangement. Any bill or claim for
payment related to a technically noncompliant
compensation arrangement shall not be subject
to the sanctions under this subsection and
shall be payable after a voluntary disclosure
is made as described in clause (iii).
``(v) Compensation arrangement
requirements.--For purposes of clause
(iii)(III), the requirements described in this
clause, with respect to a compensation
arrangement, are the following:
``(I) The compensation arrangement
is technically noncompliant (as defined
by subparagraph (C)).
``(II) The compensation arrangement
has been cured of the technical
noncompliance, or is otherwise
terminated.
``(III) In the case of technical
noncompliance described in subparagraph
(C)(i), the compensation arrangement is
consistent with fair market value, and
the remuneration under the arrangement
is not determined in a manner that
takes into account directly or
indirectly the volume or value of any
referrals.
``(C) Definition technical noncompliance.--For
purposes of this paragraph, the term `technical
noncompliance' means, with respect to a compensation
arrangement, such 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 one
or more parties to the arrangement; or
``(iii) the arrangement became in violation
of such subsection by reason of its expiration.
``(D) Applicability to pre-enactment disclosures to
relieve backlog.--In addition to the application of
this paragraph to technically noncompliant compensation
arrangements disclosed on or after the date of the
enactment of this paragraph, 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 Administrator
of the Centers for Medicare & Medicaid 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.''.
SEC. 3. CLARIFICATION OF THE WRITING REQUIREMENT AND SIGNATURE
REQUIREMENT FOR ARRANGEMENTS PURSUANT TO THE STARK RULE
UNDER MEDICARE.
(a) Writing Requirement.--Section 1877(h)(1) of the Social Security
Act (42 U.S.C. 1395nn(h)(1)) is amended by adding at the end the
following new subparagraph:
``(D) Written requirement clarified.--In the case of any
requirement pursuant to this section for a compensation
arrangement to be in writing, such requirement shall be
satisfied by such means as determined by the Secretary,
including by a collection of documents, including
contemporaneous documents evidencing the course of conduct
between the parties involved.''.
(b) Signature Requirement.--Section 1877(e) of the Social Security
Act (42 U.S.C. 1395nn(e)) is amended--
(1) in paragraph (1)(A)(i), by inserting ``before or not
later than 90 days after the effective date of the lease''
after ``signed by the parties'';
(2) in paragraph (1)(B)(i), by inserting ``before or not
later than 90 days after the effective date of the lease''
after ``signed by the parties''; and
(3) in paragraph (3)(A)(i), by inserting ``before or not
later than 90 days after the effective date of the
arrangement'' after ``signed by the parties''.
SEC. 4. INDEFINITE HOLDOVER FOR LEASE ARRANGEMENTS AND PERSONAL
SERVICES ARRANGEMENTS PURSUANT TO THE STARK RULE UNDER
MEDICARE.
Section 1877 of the Social Security Act (42 U.S.C. 1395nn) is
amended--
(1) in subsection (e)--
(A) in paragraph (1), by adding at the end the
following new subparagraph:
``(C) Holdover lease arrangements.--In the case of
a holdover lease arrangement for the lease of office
space or equipment, which immediately follows a lease
arrangement described in subparagraph (A) for the use
of such office space or subparagraph (B) for the use of
such equipment and that expired after a term of at
least one year, payments made by the lessee to the
lessor pursuant to such holdover lease arrangement,
if--
``(i) the lease arrangement met the
conditions of subparagraph (A) for the lease of
office space or subparagraph (B) for the use of
equipment when the arrangement expired;
``(ii) the holdover lease arrangement is on
the same terms and conditions as the
immediately preceding arrangement; and
``(iii) the holdover arrangement continues
to satisfy the conditions of subparagraph (A)
for the lease of office space or subparagraph
(B) for the use of equipment.''; and
(B) in paragraph (3), by adding at the end the
following new subparagraph:
``(C) Holdover personal service arrangement.--In
the case of a holdover personal service arrangement,
which immediately follows an arrangement described in
subparagraph (A) that expired after a term of at least
one year, remuneration from an entity pursuant to such
holdover personal service arrangement, if--
``(i) the personal service arrangement hmet
the conditions of subparagraph (A) when the
arrangement expired;
``(ii) the holdover personal service
arrangement is on the same terms and conditions
as the immediately preceding arrangement; and
``(iii) the holdover arrangement continues
to satisfy the conditions of subparagraph
(A).''; and
(2) in subsection (h)(1), as amended by section 3(a)--
(A) in the heading, by inserting ``; holdover
arrangement'' after ``remuneration''; and
(B) by adding at the end the following new
subparagraph:
``(E) Holdover arrangement.--The term `holdover
arrangement' means an arrangement, with respect to an agreement
(including a lease or other arrangement) that has expired but
as of the date of such expiration had been in compliance with
the applicable requirements of this section, under which the
parties to such expired agreement have, since such date of
expiration, continued to perform under the terms and conditions
of such expired agreement.''.
<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.
Referred to the Subcommittee on Health.
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