Stark Administrative Simplification Act of 2017
This bill establishes alternative protocols and sanctions for inadvertent technical noncompliance with the Stark Rule against self-referral under Medicare. "Technical noncompliance" means, with respect to a compensation arrangement, that: (1) the agreement is not signed by one or more parties to the arrangement, (2) the arrangement was a holdover arrangement for a period longer than is allowed by the Centers for Medicare & Medicaid Services, or (3) documentation of the arrangement contains specified identifying information but is otherwise insufficient to satisfy the writing requirement of an applicable exception.
[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3726 Introduced in House (IH)]
<DOC>
115th CONGRESS
1st Session
H. R. 3726
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
September 11, 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 of the Social Security Act (42 U.S.C. 1395nn) is
amended by adding at the end the following new subsection:
``(j) Self-Disclosure Protocols.--
``(1) In general.--Beginning one year after the date of the
enactment of this subsection--
``(A) an entity or individual may voluntarily
disclose a compensation arrangement with actual or
potential inadvertent technical noncompliance with
subsection (a)(1) (as defined in paragraph (3)(G))
pursuant to either the self-referral disclosure
protocol (defined in paragraph (2)) or the alternative
protocol for technical noncompliance under paragraph
(3);
``(B) disclosures voluntarily withdrawn from the
alternative protocol for technical noncompliance may be
submitted to the self-referral disclosure protocol; and
``(C) an entity that, prior to the establishment of
the alternative protocol for technical noncompliance,
disclosed to the self-referral disclosure protocol a
compensation arrangement that was in inadvertent
technical noncompliance with subsection (a)(1), may
elect, not later than one year after such alternative
protocol is established, to withdraw such disclosure
from the self-referral disclosure protocol and instead
submit the disclosure to such alternative protocol.
``(2) Self-referral disclosure protocol.--The term `self-
referral disclosure protocol' or `SRDP' means the protocol
specified in section 6409 of Public Law 111-148.
``(3) Alternative protocol for inadvertent technical
noncompliance.--
``(A) In general.--The Secretary shall establish,
not later than one year after the date of the enactment
of this subsection, an alternative protocol for
technical noncompliance (in this subsection referred to
as the `APTN') to enable entities to disclose
arrangements that were previously in inadvertent
technical noncompliance with subsection (a)(1) and,
upon the Secretary's acceptance of the disclosure, make
payment of a civil monetary penalty. Payment of such
civil monetary penalty for an arrangement shall resolve
only overpayments due and owing as a result of such
arrangement's inadvertent technical noncompliance with
this section. The provisions of section 6409 of Public
Law 111-148 shall not apply to this subsection.
``(B) Disclosure requirements.--Arrangements
disclosed to the APTN must--
``(i) involve only inadvertent technical
noncompliance with subsection (a)(1) that was
ended by termination or expiration of the
arrangement, or by action of the parties to the
arrangement to resolve the technical
noncompliance, prior to the date of submission
of the disclosure to the APTN;
``(ii) be made in the form and manner
specified by the Secretary on the public
Internet website of the Centers for Medicare &
Medicaid Services and include descriptions of--
``(I) the compensation arrangement
that was in technical noncompliance
with subsection (a)(1);
``(II) how and when the technical
noncompliance with subsection (a)(1)
was ended or the arrangement was
otherwise terminated; and
``(III) how the remuneration paid
under the compensation arrangement
being disclosed was--
``(aa) consistent with the
fair market value of the items
and services that were provided
under the compensation
arrangement; and
``(bb) not determined in a
manner that directly or
indirectly takes into account
the volume or value of
referrals or other business
generated between the parties;
``(iii) include a form settlement agreement
provided by the Secretary signed by the entity;
and
``(iv) include a certification from the
entity that, to the best of the entity's
knowledge, the information provided is truthful
information and is based on a good faith effort
to bring the matter to the Secretary's
attention.
``(C) Acceptance or rejection of disclosure by the
secretary.--The following rules shall apply to the
acceptance or rejection of a disclosure under the APTN:
``(i) The Secretary shall accept or reject
a complete, accurate, and timely disclosure.
``(ii) Upon receipt of a disclosure, the
Secretary shall notify the disclosing party of
such receipt.
``(iii) The Secretary may request
additional information from the disclosing
party.
``(iv) Upon acceptance by the Secretary,
the Secretary shall notify the disclosing party
in writing of such acceptance.
``(v) The disclosure shall be rejected if--
``(I) the disclosing party fails to
furnish the additional information
requested by the Secretary in such form
and manner as the Secretary may
specify; or
``(II) in the Secretary's sole
determination, the noncompliance
disclosed did not meet the disclosure
requirements specified in subparagraph
(B).
``(vi) The disclosure shall be accepted if
the Secretary--
``(I) has issued a written notice
to the disclosing party that the
disclosure is determined to satisfy the
requirements for disclosures under this
section; or
``(II) has not rejected a complete,
accurate, and timely disclosure that
satisfies each of the requirements for
disclosures under this section and 180
calendar days have passed since
notification of receipt by the
Secretary of the disclosure.
``(vii) In determining whether to accept a
disclosure, the Secretary may reasonably rely
on the information and certifications included
in the disclosure.
``(D) Withdrawal of disclosure.--Prior to
acceptance or rejection of a disclosure by the
Secretary, an entity may voluntarily withdraw such
disclosure from the APTN.
``(E) Civil monetary penalties pursuant to the
alternative protocol for technical noncompliance.--
``(i) In general.--Subject to clause (ii),
for each arrangement disclosed under this
subsection and accepted under subparagraph (C),
the Secretary shall impose a single civil
monetary penalty of--
``(I) $5,000, in the case in which
disclosure of the inadvertent
technically noncompliant compensation
arrangement was submitted to the
Secretary not later than the date that
is one year after the initial date of
inadvertent technical noncompliance
with subsection (a)(1); or
``(II) $10,000, in the case in
which the disclosure of the technically
noncompliant compensation arrangement
was submitted to the Secretary--
``(aa) after the date that
is more than one year after the
initial date of the entity's
inadvertent technical
noncompliance with subsection
(a)(1); and
``(bb) not after the date
that is 3 years (or, in the
case of a disclosure submitted
after the 5th year for which
this subsection applies, the
date that is 2 years) from the
initial date of the entity's
inadvertent technical
noncompliance with subsection
(a)(1).
``(ii) Special rule for entities that
disclosed to the aptn after withdrawing a
disclosure from the srdp.--In the case of an
entity that elects under paragraph (1)(C) to
withdraw a disclosure from the self-referral
disclosure protocol and instead submit the
disclosure to the APTN under this subsection,
in determining the applicable civil monetary
penalty under clause (i), the date of
disclosure to the self-referral disclosure
protocol (as defined in paragraph (2)) shall be
substituted for the date of disclosure to the
APTN.
``(F) Relation to advisory opinions.--The APTN
shall be separate from the advisory opinion process set
forth in regulations implementing subsection (g) of
this section.
``(G) Publication on internet website of aptn
information.--Not later than one year after the date of
the enactment of this section, the Secretary shall post
information on the public Internet website of the
Centers for Medicare & Medicaid Services to inform
relevant stakeholders of how to disclose and make
payment of a civil monetary penalty for inadvertent
technical noncompliance with subsection (a)(1).
``(H) Definitions.--In this subsection:
``(i) Technical noncompliance.--The term
`technical noncompliance with subsection
(a)(1)' means, with respect to a compensation
arrangement, that--
``(I) the arrangement is not signed
by one or more parties to the
arrangement;
``(II) following the expiration of
the arrangement, the arrangement was a
holdover arrangement for a period
longer than permitted in regulations
issued by the Secretary; or
``(III) the contemporaneous written
documentation evidencing the terms of
the arrangement identifies the parties
to the arrangement and the items,
services, space, or equipment, as
applicable, but is not sufficient to
satisfy the writing requirement of an
applicable exception.
``(ii) Inadvertent.--The term `inadvertent'
means, with respect to a compensation
arrangement that is in noncompliance, that an
entity that is a party to the compensation
arrangement did not know or should not have
known of the noncompliance.
``(I) Administration.--Chapter 35 of title 44,
United States Code, shall not apply to this subsection.
``(J) Implementation.--Notwithstanding any other
provision of law, the Secretary may implement the
provisions of this paragraph by program instruction or
otherwise.''.
<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.
Committee Consideration and Mark-up Session Held.
Ordered to be Reported (Amended) by Voice Vote.
Referred to the Subcommittee on Health.
Reported (Amended) by the Committee on Ways and Means. H. Rept. 115-479, Part I.
Reported (Amended) by the Committee on Ways and Means. H. Rept. 115-479, Part I.
Committee on Energy and Commerce discharged.
Committee on Energy and Commerce discharged.
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Placed on the Union Calendar, Calendar No. 354.