[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 1417 Introduced in Senate (IS)]







106th CONGRESS
  1st Session
                                S. 1417

 To amend title XIX of the Social Security Act to extend the authority 
  of State Medicaid fraud control units to investigate and prosecute 
  fraud in connection with Federal health care programs and abuse of 
                residents of board and care facilities.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 22, 1999

  Mr. Grassley (for himself and Mr. Breaux) introduced the following 
  bill; which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
 To amend title XIX of the Social Security Act to extend the authority 
  of State Medicaid fraud control units to investigate and prosecute 
  fraud in connection with Federal health care programs and abuse of 
                residents of board and care facilities.

    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 ``Health Care Fraud Control Act of 
1999''.

SEC. 2. EXTENSION OF AUTHORITY OF STATE MEDICAID FRAUD CONTROL UNITS.

    (a) Extension of Concurrent Authority To Investigate and Prosecute 
Fraud in Other Federal Health Care Programs.--Section 1903(q)(3) of the 
Social Security Act (42 U.S.C. 1396b(q)(3)) is amended--
            (1) by inserting ``(A)'' after ``in connection with''; and
            (2) by striking ``title.'' and inserting ``title; and (B) 
        upon the approval of the Inspector General of the relevant 
        Federal agency in a particular case or investigation, any 
        aspect of the provision of health care services and activities 
        of providers of such services under any Federal health care 
        program (as defined in section 1128B(f)(1)), if (i) the 
        suspected fraud or violation of law in such case or 
        investigation is primarily related to the State plan under this 
        title, and (ii) when such approval is granted, the Inspector 
        General of the relevant Federal agency retains the continuing 
        authority to join the case or investigation, or after 
        consultation with the entity, to replace the entity as the 
        primary agency assigned to the case or investigation.''.
    (b) Recoupment of Funds.--Section 1903(q)(5) of such Act (42 U.S.C. 
1396b(q)(5)) is amended--
            (1) by inserting ``or under any Federal health care program 
        (as so defined)'' after ``plan''; and
            (2) by adding at the end the following: ``All funds 
        collected in accordance with this paragraph shall be credited 
        exclusively to, and available for expenditure under, the 
        Federal health care program (including the State plan under 
        this title) that was subject to the activity that was the basis 
        for the collection.''.
    (c) Extension of Authority To Investigate and Prosecute Resident 
Abuse in Non-Medicaid Board and Care Facilities.--Section 1903(q)(4) of 
such Act (42 U.S.C. 1396b(q)(4)) is amended to read as follows:
            ``(4)(A) The entity has--
                    ``(i) procedures for reviewing complaints of abuse 
                or neglect of patients in health care facilities which 
                receive payments under the State plan under this title;
                    ``(ii) at the option of the entity, procedures for 
                reviewing complaints of abuse or neglect of patients 
                residing in board and care facilities; and
                    ``(iii) procedures for acting upon such complaints 
                under the criminal laws of the State or for referring 
                such complaints to other State agencies for action.
            ``(B) For purposes of this paragraph, the term `board and 
        care facility' means a residential setting which receives 
        payment (regardless of whether such payment is made under the 
        State plan under this title) from or on behalf of two or more 
        unrelated adults who reside in such facility, and for whom one 
        or both of the following is provided:
                    ``(i) Nursing care services provided by, or under 
                the supervision of, a registered nurse, licensed 
                practical nurse, or licensed nursing assistant.
                    ``(ii) A substantial amount of personal care 
                services that assist residents with the activities of 
                daily living, including personal hygiene, dressing, 
                bathing, eating, toileting, ambulation, transfer, 
                positioning, self-medication, body care, travel to 
                medical services, essential shopping, meal preparation, 
                laundry, and housework.''.
    (d) Effective Date.--The amendments made by this section take 
effect on the date of enactment of this Act.
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