3.0.0 2931 2023-01-11T13:24:19Z 2023-01-11T13:24:19Z House H HR 2013-08-01 113 From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]By Mr. COBLE:H.R. 2931.Congress has the power to enact this legislation pursuantto the following:Article I Section 8 which authorizes Congress to make rulesfor the government and regulation of the land.[Page H5346]]]> hsju00 Judiciary Committee House Standing hsju10 Constitution and Limited Government Subcommittee Referred to 2013-09-13T13:22:31Z Referred to 2013-08-01T14:03:35Z 2013-09-13 hsju10 Constitution and Limited Government Subcommittee 1 House committee actions Referred to the Subcommittee on the Constitution and Civil Justice. Committee 2013-08-01 Referred to the House Committee on the Judiciary. IntroReferral H11100 2 House floor actions hsju00 Judiciary Committee 2013-08-01 Introduced in House IntroReferral Intro-H 9 Library of Congress 2013-08-01 Introduced in House IntroReferral 1000 9 Library of Congress C000556 Rep. Coble, Howard [R-NC-6] HOWARD COBLE R NC 6 N S001157 Rep. Scott, David [D-GA-13] David Scott D GA 13 2013-08-02 False T000193 Rep. Thompson, Bennie G. [D-MS-2] BENNIE THOMPSON D MS 2 2013-09-26 False Health Accounting and auditing Comprehensive health care Evidence and witnesses Fraud offenses and financial crimes Government studies and investigations Health care costs and insurance Health information and medical records Health programs administration and funding Judicial procedure and administration Medicaid Medicare Veterans' medical care Health 00 2013-08-01 Introduced in House 2013-09-19T19:44:01Z Fairness in Health Care Claims, Guidance, and Investigations Act - Amends the False Claims Act to set forth special rules for the investigation and prosecution of false claims submitted with respect to a federal health care program (i.e., a health care program funded by the federal government, a state health care program defined by the Social Security Act, or a health plan offered under the Patient Protection and Affordable Care Act).

Requires the Attorney General to certify in writing, prior to requesting any information from a physician, hospital, or other provider or supplier of health care services in connection with an investigation reasonably expected to concern 10 or more claims submitted to a federal health care program by or on behalf of a single entity, that: (1) each agency responsible for promulgating relevant regulations, guidelines, and billing instructions relevant to any allegations of fraud has examined such regulations, guidelines, and instructions, all communications between the alleged perpetrator of the fraud and the agency, and each of the allegedly false claims; (2) the allegations under investigation are viewed as viable based on unambiguous regulations, guidelines, and billing instructions issued during the relevant time period; and (3) if proven to be true, the allegations will be pursued under the False Claims Act.

Prohibits an action against a health care provider or supplier under the False Claims Act: (1) unless the amount of damages alleged to have been sustained by the government is a material amount, (2) if a claim is submitted in good faith reliance on erroneous information or written statements of federal policy provided by a federal agency or in good faith reliance on an audit or review by an agency of the entity submitting the claim or retaining an overpayment, or (3) if a claim is submitted in substantial compliance with a model compliance plan issued by the Secretary of Health and Human Services (HHS).

Establishes the standard of proof necessary for a civil prosecution of a claim submitted with respect to a federal health care program as clear and convincing evidence (currently, a preponderance of the evidence is required for all other claims).

]]> Fairness in Health Care Claims, Guidance, and Investigations Act Display Title Fairness in Health Care Claims, Guidance, and Investigations Act Official Title as Introduced To amend the false claims provisions of title 31, United States Code, with respect to health care programs, and for other purposes. Introduced in House IH Short Titles as Introduced Fairness in Health Care Claims, Guidance, and Investigations Act Introduced in House 2013-08-01T04:00:00Z https://www.govinfo.gov/content/pkg/BILLS-113hr2931ih/xml/BILLS-113hr2931ih.xml 2013-09-13 Referred to the Subcommittee on the Constitution and Civil Justice. text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. Congressional Research Service, Library of Congress This file contains bill summaries and statuses for federal legislation. A bill summary describes the most significant provisions of a piece of legislation and details the effects the legislative text may have on current law and federal programs. Bill summaries are authored by the Congressional Research Service (CRS) of the Library of Congress. As stated in Public Law 91-510 (2 USC 166 (d)(6)), one of the duties of CRS is "to prepare summaries and digests of bills and resolutions of a public general nature introduced in the Senate or House of Representatives". For more information, refer to the User Guide that accompanies this file.