I 112th CONGRESS 1st Session H. R. 173 IN THE HOUSE OF REPRESENTATIVES January 5, 2011 Mr. Stearns introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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 titles XI and XVIII of the Social Security Act to provide increased civil and criminal penalties for acts involving fraud and abuse under the Medicare Program and to increase the amount of the surety bond required for suppliers of durable medical equipment.

1.

Short title

This Act may be cited as the Medicare Fraud Prevention Act of 2011.

2.

Increased civil money penalties and criminal fines for medicare fraud and abuse

(a)

Increased Civil Money Penalties

Section 1128A of the Social Security Act (42 U.S.C. 1320a–7a) is amended— (1)in subsection (a), in the flush matter following paragraph (10)— (A)by striking $10,000 each place it appears and inserting $20,000; (B)by striking $15,000 and inserting $30,000; and (C)by striking $50,000 each place it appears and inserting $100,000; and Bracketed addition made to account for amendments made by PPPACA PL111–148. Please review to be sure that addition reflects policy intent. (2)in subsection (b)— (A)in paragraph (1), in the flush matter following subparagraph (B), by striking $2,000 and inserting $4,000; (B)in paragraph (2), by striking $2,000 and inserting $4,000; and (C)in paragraph (3)(A)(i), by striking $5,000 and inserting $10,000. (b)

Increased Criminal Fines

Section 1128B of the Social Security Act (42 U.S.C. 1320a–7b) is amended— (1)in subsection (a), in the flush matter following paragraph (6)— (A)by striking $25,000 and inserting $100,000; and (B)by striking $10,000 and inserting $20,000; (2)in subsection (b)— (A)in paragraph (1), in the flush matter following subparagraph (B), by striking $25,000 and inserting $100,000; and (B)in paragraph (2), in the flush matter following subparagraph (B), by striking $25,000 and inserting $100,000; (3)in subsection (c), by striking $25,000 and inserting $100,000; (4)in subsection (d), in the second flush matter following subparagraph (B), by striking $25,000 and inserting $100,000; and (5)in subsection (e), by striking $2,000 and inserting $4,000. (c)

Effective Date

The amendments made by this section shall apply to civil money penalties and fines imposed for actions taken on or after the date of enactment of this Act.

3.

Increased sentences for felonies involving medicare fraud and abuse

(a)

False Statements and Representations

Section 1128B(a) of the Social Security Act (42 U.S.C. 1320a–7b(a)) is amended, in clause (i) of the flush matter following paragraph (6), by striking not more than five years and inserting not more than 10 years. (b)

Anti-Kickback

Section 1128B(b) of the Social Security Act (42 U.S.C. 1320a–7b(b)) is amended— (1)in paragraph (1), in the flush matter following subparagraph (B), by striking not more than five years and inserting not more than 10 years; and (2)in paragraph (2), in the flush matter following subparagraph (B), by striking not more than five years and inserting not more than 10 years. (c)

False Statement or Representation With Respect to Conditions or Operations of Facilities

Section 1128B(c) of the Social Security Act (42 U.S.C. 1320a–7b(c)) is amended by striking not more than five years and inserting not more than 10 years. (d)

Excess Charges

Section 1128B(d) of the Social Security Act (42 U.S.C. 1320a–7b(d)) is amended, in the second flush matter following subparagraph (B), by striking not more than five years and inserting not more than 10 years. (e)

Effective Date

The amendments made by this section shall apply to criminal penalties imposed for actions taken on or after the date of enactment of this Act.

4.

Increased surety bond requirement for suppliers of dme

(a)

In General

Section 1834(a)(16)(B) of the Social Security Act (42 U.S.C. 1395m(a)(16)(B)) is amended by striking $50,000 and inserting $500,000. (b)

Effective Date

The amendment made by this section shall apply to the issuance (or renewal) of a provider number for a supplier of durable medical equipment on or after the date of enactment of this Act.