[Congressional Record Volume 165, Number 34 (Monday, February 25, 2019)]
[House]
[Pages H2053-H2055]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
{time} 1645
STRENGTHENING THE HEALTH CARE FRAUD PREVENTION TASK FORCE ACT OF 2019
Mr. ENGEL. Mr. Speaker, I move to suspend the rules and pass the bill
(H.R. 525) to amend title XI of the Social Security Act to direct the
Secretary of Health and Human Services to establish a public-private
partnership for purposes of identifying health care waste, fraud, and
abuse.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 525
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 ``Strengthening the Health
Care Fraud Prevention Task Force Act of 2019''.
[[Page H2054]]
SEC. 2. PUBLIC-PRIVATE PARTNERSHIP FOR HEALTH CARE WASTE,
FRAUD, AND ABUSE DETECTION.
(a) In General.--Section 1128C(a) of the Social Security
Act (42 U.S.C. 1320a-7c(a)) is amended by adding at the end
the following new paragraph:
``(6) Public-private partnership for waste, fraud, and
abuse detection.--
``(A) In general.--Under the program described in paragraph
(1), there is established a public-private partnership (in
this paragraph referred to as the `partnership') of health
plans, Federal and State agencies, law enforcement agencies,
health care anti-fraud organizations, and any other entity
determined appropriate by the Secretary (in this paragraph
referred to as `partners') for purposes of detecting and
preventing health care waste, fraud, and abuse.
``(B) Contract with trusted third party.--In carrying out
the partnership, the Secretary shall enter into a contract
with a trusted third party for purposes of carrying out the
duties of the partnership described in subparagraph (C).
``(C) Duties of partnership.--The partnership shall--
``(i) provide technical and operational support to
facilitate data sharing between partners in the partnership;
``(ii) analyze data so shared to identify fraudulent and
aberrant billing patterns;
``(iii) conduct aggregate analyses of health care data so
shared across Federal, State, and private health plans for
purposes of detecting fraud, waste, and abuse schemes;
``(iv) identify outlier trends and potential
vulnerabilities of partners in the partnership with respect
to such schemes;
``(v) refer specific cases of potential unlawful conduct to
appropriate governmental entities;
``(vi) convene, not less than annually, meetings with
partners in the partnership for purposes of providing updates
on the partnership's work and facilitating information
sharing between the partners;
``(vii) enter into data sharing and data use agreements
with partners in the partnership in such a manner so as to
ensure the partnership has access to data necessary to
identify waste, fraud, and abuse while maintaining the
confidentiality and integrity of such data;
``(viii) provide partners in the partnership with plan-
specific, confidential feedback on any aberrant billing
patterns or potential fraud identified by the partnership
with respect to such partner;
``(ix) establish a process by which entities described in
subparagraph (A) may enter the partnership and requirements
such entities must meet to enter the partnership;
``(x) provide appropriate training, outreach, and education
to partners based on the results of data analyses described
in clauses (ii) and (iii); and
``(xi) perform such other duties as the Secretary
determines appropriate.
``(D) Substance use disorder treatment analysis.--Not later
than 2 years after the date of the enactment of the
Strengthening the Health Care Fraud Prevention Task Force Act
of 2019, the trusted third party with a contract in effect
under subparagraph (B) shall perform an analysis of aberrant
or fraudulent billing patterns and trends with respect to
providers and suppliers of substance use disorder treatments
from data shared with the partnership.
``(E) Executive board.--
``(i) Executive board composition.--
``(I) In general.--There shall be an executive board of the
partnership comprised of representatives of the Federal
Government and representatives of the private sector selected
by the Secretary.
``(II) Chairs.--The executive board shall be co-chaired by
one Federal Government official and one representative from
the private sector.
``(ii) Meetings.--The executive board of the partnership
shall meet at least once per year.
``(iii) Executive board duties.--The duties of the
executive board shall include the following:
``(I) Providing strategic direction for the partnership,
including membership criteria and a mission statement.
``(II) Communicating with the leadership of the Department
of Health and Human Services and the Department of Justice
and the various private health sector associations.
``(F) Reports.--Not later than September 30, 2021, and
every 2 years thereafter, the Secretary shall submit to
Congress and make available on the public website of the
Centers for Medicare & Medicaid Services a report
containing--
``(i) a review of activities conducted by the partnership
over the 2-year period ending on the date of the submission
of such report, including any progress to any objectives
established by the partnership;
``(ii) any savings voluntarily reported by health plans
participating in the partnership attributable to the
partnership during such period;
``(iii) any savings to the Federal Government attributable
to the partnership during such period;
``(iv) any other outcomes attributable to the partnership,
as determined by the Secretary, during such period; and
``(v) a strategic plan for the 2-year period beginning on
the day after the date of the submission of such report,
including a description of any emerging fraud and abuse
schemes, trends, or practices that the partnership intends to
study during such period.
``(G) Funding.--The partnership shall be funded by amounts
otherwise made available to the Secretary for carrying out
the program described in paragraph (1).
``(H) Transitional provisions.--To the extent consistent
with this subsection, all functions, personnel, assets,
liabilities, and administrative actions applicable on the
date before the date of the enactment of this paragraph to
the National Fraud Prevention Partnership established on
September 17, 2012, by charter of the Secretary shall be
transferred to the partnership established under subparagraph
(A) as of the date of the enactment of this paragraph.
``(I) Nonapplicability of faca.--The provisions of the
Federal Advisory Committee Act shall not apply to the
partnership established by subparagraph (A).
``(J) Implementation.--Notwithstanding any other provision
of law, the Secretary may implement the partnership
established by subparagraph (A) by program instruction or
otherwise.
``(K) Definition.--For purposes of this paragraph, the term
`trusted third party' means an entity that--
``(i) demonstrates the capability to carry out the duties
of the partnership described in subparagraph (C);
``(ii) complies with such conflict of interest standards
determined appropriate by the Secretary; and
``(iii) meets such other requirements as the Secretary may
prescribe.''.
(b) Potential Expansion of Public-Private Partnership
Analyses.--Not later than 2 years after the date of the
enactment of this Act, the Secretary of Health and Human
Services shall conduct a study and submit to Congress a
report on the feasibility of the partnership (as described in
section 1128C(a)(6) of the Social Security Act, as added by
subsection (a)) establishing a system to conduct real-time
data analysis to proactively identify ongoing as well as
emergent fraud trends for the entities participating in the
partnership and provide such entities with real-time feedback
on potentially fraudulent claims. Such report shall include
the estimated cost of and any potential barriers to the
partnership establishing such a system.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New
York (Mr. Engel) and the gentleman from Ohio (Mr. Latta) each will
control 20 minutes.
The Chair recognizes the gentleman from New York.
General Leave
Mr. ENGEL. Mr. Speaker, I ask unanimous consent that all Members may
have 5 legislative days in which to revise and extend their remarks and
include extraneous material on H.R. 525.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from New York?
There was no objection.
Mr. ENGEL. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise today in support of H.R. 525, the Strengthening
the Health Care Fraud Prevention Task Force Act of 2019. This
bipartisan bill would authorize the Healthcare Fraud Prevention
Partnership, and improve and expand the task force's ability to fight
waste, fraud, and abuse throughout our healthcare system.
The Healthcare Fraud Prevention Partnership is a public-private
partnership between the Department of Health and Human Services,
insurance companies, Federal and State law enforcement agencies, and
State healthcare agencies. The partnership aims to improve the
detection and prevention of healthcare fraud by facilitating the
exchange of data and information between the public and private sectors
on fraud trends and successful antifraud practices.
The legislation we are considering today would authorize the
partnership, require the partnership to report regularly to Congress,
and give the agency new tools to enhance and expand its capabilities.
We must continue to work on a bipartisan basis to enhance our fraud
detection capabilities.
I support this legislation and I urge my colleagues to continue to
work together to find meaningful solutions to root out fraud, waste,
and abuse in our healthcare system.
Mr. Speaker, I reserve the balance of my time.
House of Representatives,
Committee on Ways and Means,
Washington, DC, February 25, 2019.
Hon. Frank Pallone,
Chairman, Energy and Commerce Committee,
Washington, DC.
Dear Chairman Pallone: In recognition of the desire to
expedite consideration of H.R. 525, Strengthening the Health
Care Fraud Prevention Task Force Act of 2019, the Committee
on Ways and Means agrees to waive formal consideration of the
bill as to provisions that fall within the rule X
jurisdiction of the Committee on Ways and Means.
[[Page H2055]]
The Committee on Ways and Means takes this action with the
mutual understanding that we do not waive any jurisdiction
over the subject matter contained in this or similar
legislation, and the Committee will be appropriately
consulted and involved as the bill or similar legislation
moves forward so that we may address any remaining issues
within our jurisdiction. The Committee also reserves the
right to seek appointment of an appropriate number of
conferees to any House-Senate conference involving this or
similar legislation.
Finally, I would appreciate your response to this letter
confirming this understanding, and would ask that a copy of
our exchange of letter on this matter be included in the
Congressional Record during floor consideration of H.R. 525.
Sincerely,
Richard E. Neal,
Chairman.
____
House of Representatives,
Committee on Energy and Commerce,
Washington, DC, February 25, 2019.
Hon. Richard E. Neal,
Chairman, Ways and Means,
Washington, DC.
Dear Chairman Neal: Thank you for consulting with the
Committee on Energy and Commerce and agreeing to discharge
H.R. 525, Strengthening the Health Care Fraud Prevention Task
Force Act of 2019 from further consideration, so that the
bill may proceed expeditiously to the House floor.
I agree that your forgoing further action on this measure
does not in any way diminish or alter the jurisdiction of
your committee or prejudice its jurisdictional prerogatives
on this measure or similar legislation in the future. I would
support your effort to seek appointment of an appropriate
number of conferees from your committee to any House-Senate
conference on this legislation.
I will ensure our letters on H.R. 525 are entered into the
Congressional Record during floor consideration of the bill.
I appreciate your cooperation regarding this legislation and
look forward to continuing to work together as this measure
moves through the legislative process.
Sincerely,
Frank Pallone, Jr.,
Chairman.
Mr. LATTA. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of H.R. 525, the Strengthening the
Health Care Fraud Prevention Task Force Act of 2019, introduced by the
Energy and Commerce Committee Republican Leader Walden and Chairman
Pallone.
This legislation will codify the Healthcare Fraud Prevention
Partnership, which is currently operated by the Centers for Medicare
and Medicaid Services and is a voluntary public-private partnership
between the Federal Government, State agencies, law enforcement,
private health insurance plans, and healthcare antifraud associations.
The partnership was established by the Obama administration and the
Trump administration recommended codifying it, solidifying the
bipartisan nature of revealing and halting scams that cut across public
and private payers.
H.R. 525 will ensure the continued operation of this important
partnership to detect and prevent healthcare fraud through public-
private information sharing, streamlining analytical tools and data,
and providing a forum for government and industry experts to exchange
successful antifraud practices.
This bill before us today is the product of bipartisan cooperation,
as well as engagement with the Department of Health and Human Services
and industry stakeholders.
Originally introduced in the 115th Congress, this legislation worked
its way through the Committee on Energy and Commerce in a transparent
manner and currently enjoys the support of the chairmen and republican
leaders of both the Committee of Energy and Commerce and the Committee
on Ways and Means.
Mr. Speaker, I urge passage of this bill, and I yield back the
balance of my time.
Mr. ENGEL. Mr. Speaker, I urge my colleagues to work together to find
meaningful solutions to root out waste, fraud, and abuse in our
healthcare system, and I yield back the balance of my time.
Mr. WALDEN. Mr. Speaker, I rise today in support of H.R. 525, the
Health Care Fraud Prevention Task Force Act.
This bipartisan bill--which I introduced with Chairman Frank Pallone,
and which is supported by Ways and Means Chairman Richard Neal and
Republican Leader Kevin Brady--is a commonsense, bipartisan bill to
improve the integrity of our nation's health care system.
The Centers for Medicare and Medicaid Services (CMS) currently
operates the Health Care Fraud Prevention Partnership--a voluntary
collaboration between the federal government, state agencies, law
enforcement, private health insurance plans, and anti-fraud
associations. Together, this group works to detect and prevent fraud
that threatens to undermine our nation's health care system. This
program was created by the Obama Administration, and the Trump
Administration has recommended codifying it into law. The bill before
us today does just that.
Mr. Speaker, last Congress, the House passed this legislation by
voice vote but unfortunately, we were unable to get this bill through
the Senate and to the President's desk before the end of the Congress.
In fact, the House Energy and Commerce Committee had 148 bills pass
the House last Congress, and 93 percent of them received bipartisan
votes. I'd like to thank Chairman Pallone for continuing in that
bipartisan spirit by helping to bring this bill back to the floor
today.
I urge passage of H.R. 525.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from New York (Mr. Engel) that the House suspend the rules
and pass the bill, H.R. 525.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill was passed.
A motion to reconsider was laid on the table.
____________________