[Federal Register Volume 62, Number 58 (Wednesday, March 26, 1997)]
[Notices]
[Pages 14443-14445]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-7581]


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DEPARTMENT OF JUSTICE

Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Justice Management Division, DOJ.

ACTION: Notice of information collection under emergency review; U.S. 
Department of Justice and U.S. Department of Health and Human Services 
Application for Funds under the Health Care Fraud and Abuse Control 
Program.

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    The Department of Justice (DOJ), Justice Management Division has 
submitted the following information collection request to the Office of 
Management and Budget (OMB) for review and approval in accordance with 
the emergency review procedures of the paperwork Reduction Act of 1995. 
This notice serves the following two purposes:
    A. Notification of the public on the requirement necessary to apply 
for Federal funding under the Health Care Fraud and Abuse Control 
Program.
    B. Compliance with the requirements of the Paperwork Reduction Act 
of 1995.

A. Notification to the Public on the Requirements Necessary To Apply 
for Federal Funding Under the Health Care Fraud and Abuse Control 
Program

    All proposals must be received on or before April 25, 1997. All 
proposals must be submitted to the Office of Inspector General, 
Attention: John E. Hartwig, Deputy Inspector General for 
Investigations, U.S. Department of Health and Human Services, Room 5250 
Cohen Building, 330 Independence Avenue, SW., Washington, DC 20201.

Background

    The Health Insurance Portability and Accountability Act of 1996 
added Section 1128C to the Social Security Act, which directs the 
Attorney General and the Secretary of HHS, acting through the HHS 
Inspector General, to establish a National Health Care Fraud and Abuse 
Control Program to achieve the goals of: (1) Coordinating Federal, 
State and local law enforcement program to control fraud and abuse with 
respect to health plans; (2) conducting investigations, audits, 
evaluations and inspections relating to the delivery of and payment for 
health care in the United States; (3) facilitating enforcement of 
civil, criminal and administrative statues applicable to health care 
fraud and abuse; (4) providing industry guidance relating to fraudulent 
health care practices; and (5) establishing a national data bank to 
receive and report final adverse actions against health care providers. 
In accordance with the statute, the Attorney General and the Secretary 
developed Guidelines for Implementation of the Health Care Fraud and 
Abuse Control Program.
    To fund the coordinating anti-fraud effort, the statute directs 
that an amount equalling recoveries derived from health care cases--
including civil monetary penalties, fines, forfeitures, and damages 
assessed in criminal, civil or administrative health care cases, but 
excluding restitution due to the victim, funds awarded to a relator, or 
as otherwise authorized by law--be transferred to the Federal Hospital 
Insurance Trust Fund. Monies are appropriated from the Trust Fund to a 
newly created expenditure account, called the Health Care Fraud and 
Abuse Control Account in amounts that the Secretary and Attorney 
General annually certify are necessary to finance the administration 
and operation of the Fraud and Abuse Control Program.
    The purpose of this Notice is to solicit proposals from those 
Federal, State and local agencies that are currently involved in health 
care fraud and abuse control (other than the Departments of Justice and 
Health and Human Services) for projects or activities that promote the 
objectives of the Fraud and Abuse Control Program to be supported with 
these funds. This action is authorized under 42 U.S.C. 1320 a-7 and 42 
U.S.C. 1395 b-1.

Availability of Funds

    Approximately $3.5 million will be available in Fiscal Year 1997 to 
support approved proposals. Funds may be used to cover costs (including 
equipment,

[[Page 14444]]

salaries and benefits, travel and training) that directly further the 
Health Care Fraud and Abuse Control Program, including the costs of 
investigating and prosecuting health care matters (through civil, 
criminal and administrative proceedings), conducting audits, and 
inspections and evaluations relating to health care, and provider and 
consumer education.
    If a proposal is selected for funding, the Departments of Justice 
and HHS have no obligation to provide any additional future funding 
beyond the first budget period. Because the overall amount of available 
funds may fluctuate widely from year to year, there is no presumption 
of continued funding in succeeding years. Invitations to submit 
proposals for this money will be announced in the Federal Register each 
year that such funds are available, and all interested recipients must 
reapply.
    Funds may be allocated only to (1) supplement, and not supplant, 
current levels of effort of fraud and abuse control related activities, 
or (2) undertake a new fraud or abuse control related activity. Funds 
may not be used to replace existing funding for a fraud and abuse 
function. Additionally, funds may not be included as cost sharing or 
matching contributions for any federally-assisted project or program.

Proposal Submission Process and Contents

    Proposals will be accepted from Federal, State and local government 
entities engaged in health care fraud and abuse control in the United 
States. All proposals must be received on or before April 25, 1997. All 
proposals must be submitted to the Office of Inspector General, 
Attention: John E. Hartwig, Deputy Inspector General for 
Investigations, U.S. Department of Health and Human Services, Room 5250 
Cohen Building, 330 Independence Avenue, S.W., Washington, D.C. 20201.
    Proposals must be submitted by the head of the entity, or the head 
of the law enforcement unit within the entity. For example, 
applications will be accepted from officials such as the Secretary or 
Inspector General of a Federal agency, and the Governor, Auditor 
General or Attorney General of a State.
    Submissions must include sufficient information to determine that 
the proposed activity meets the requirements described in this Notice, 
as supplemented by the Health Insurance Portability and Accountability 
Act of 1996 and implementing Guidelines.
    Proposals must address the following:
    1. A description of the activities proposed for funding, including 
a timeline for implementation of the proposed activities. The narrative 
must describe in detail how the proposed activity is consistent with 
and will promote the Fraud and Abuse Control Program, such as how the 
program will prevent or reduce health care fraud and abuse in the 
country, or will assist in recovering health care funds that have been 
improperly expended due to fraud and abuse.
    2. A comprehensive spending plan that links costs to projected 
tasks and time frames.
    3. A description of the entity's history and experience in 
conducting activities relating to the prevention, detection, 
investigation and prosecution (civil, criminal and administrative) of 
health care fraud and abuse.
    4. A description of how the entity intends to coordinate its funded 
activities with HHS and the Department of Justice.
    5. A description of the evaluation procedures to be used by the 
entity for monitoring progress of the proposed activities, and 
assessing their effectiveness in combating health care fraud and abuse.
    6. A description of any innovative techniques to be utilized in 
addressing fraud and abuse in health care.
    7. A statement that requested funds will supplement and not 
supplant existing funding for controlling health care fraud and abuse.
    8. A statement as to the entity's legal authority to receive funds 
under this announcement and expend them on the requested activities.

Review Process and Criteria

    All proposals submitted by the closing date and meeting the 
requirements of this Notice will be reviewed and evaluated by a panel 
of representatives from the Department of Justice and HHS. The panel 
will acknowledge receipt of all timely proposals. After review, the 
panel will make recommendations for funding to the Secretary and the 
Attorney General. All final funding decisions are at the discretion of 
the Attorney General and the Secretary who will jointly certify the 
award of funds in accordance with the Act. Awards are contingent on the 
availability of funds. Proposals will generally either be approved or 
disapproved at the requested funding level, Applicants may submit more 
than one proposal. Each proposal will be evaluated primarily on the 
basis of how well it will relate to and promote the overall Health Care 
Fraud and Abuse Program, and the above listed criteria. Other factors 
will include: the soundness of the objectives of the proposed project; 
the reasonableness of cost in relation to the anticipated results, the 
entity's experience in the area of prevention and detection of health 
care fraud and abuse, the entity's institutional ability to achieve the 
stated goals, the entity's willingness to coordinate its activities 
closely with the Departments of Justice and HHS, the entity's ability 
to measure and report on the progress and achievement of the 
activities, the availability and adequacy of resources to conduct the 
proposed activities, and its relationship to other projects already 
completed or in progress.

Funding Instrument

    The Attorney General and the Secretary of HHS expect to award funds 
via interagency transfer to any Federal entities whose proposals are 
approved for funding. With respect to other applicants, funds will be 
awarded via grant, cooperative agreement, or other authorized funding 
mechanism. The Secretary of HHS and the Attorney General reserve the 
right to use the form of funding agreement determined to be most 
appropriate.
    Successful applicants will be required to report no less often than 
annually to the Departments of Justice and HHS evaluating the progress 
of the funded activities, and assessing their effectiveness in 
combating health care fraud and abuse. The HHS-OIG may also 
independently conduct a review of any activity funded hereunder.

    Note: If you are applying for funding under the Health Care 
Fraud and Abuse Control Program complete only ``Section A'' above.

B. Compliance With the Requirements of the Paperwork Reduction Act of 
1995

    The proposed information collection is published to obtain comments 
from the public and affected agencies. Emergency review and approval of 
this collection has been requested from OMB by March 19, 1997. If 
granted, this emergency approval is only valid for 180 days. Comments 
should be directed to OMB, Ms. Victoria Wassmer, 202-395-5871, Office 
of Information and Regulatory Affairs, Attention: Department of Justice 
Desk Officer, Washington, D.C. 20503.
    Public comments are encouraged and will be accepted until 60 days 
from the date published in the Federal Register. Written comments and 
suggestions from the public and affected agencies concerning the 
proposed collection of information are encouraged. Your comments should 
address one or more of the following four points:

    (1) Evaluate whether the proposed collection of information is 
necessary for the

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proper performance of the functions of the agency, including whether 
the information will have practical utility;
    (2) Evaluate the accuracy of the agencies' estimate of the 
burden of the proposed collection of information, including the 
validity of the methodology and assumptions used;
    (3) Enhance the quality, utility, and clarity of the information 
to be collected; and
    (4) Minimize the burden of the collection of information on 
those who are to respond, including through the use of appropriate 
automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology, e.g., 
permitting electronic submission of responses.

Overview of This Information Collection

    (1) Type of Information Collection: New collection.
    (2) Title of the Form/Collection: U.S. Department of Justice and 
U.S. Department of Health and Human Services Health Care Fraud and 
Abuse Control Program.
    (3) Agency form number, if any, and the applicable component of the 
Department of Justice sponsoring the collection: Form: None. Justice 
Management Division, United States Department of Justice.
    (4) Affected public who will be asked or required to respond, as 
well as a brief abstract: Federal, State and local governments. See 
item ``A'' above.
    (5) An estimate of the total number of respondents and the amount 
of time estimated for an average respondent to respond: 75 responses at 
40 hours per response.
    (6) An estimate of the total public burden (in hours) associated 
with the collection: 3,000 annual burden hours.
    If you have additional comments, suggestions, or need additional 
information, please contact the Office of Inspector General, Attention: 
John E. Hartwig, Deputy Inspector General for Investigations, U.S. 
Department of Health and Human Services, Room 5250 Cohen Building, 330 
Independence Avenue, S.W., Washington, D.C. 20201.
    If additional information is required, contact: Mr. Robert B. 
Briggs, Clearance Officer, United States Department of Justice, 
Information Management and Security Staff, Justice Management Division 
Suite 850, Washington Center, 1001 G Street NW, Washington, D.C. 20530.

    Dated: March 20, 1997.
Robert B. Briggs,
Department Clearance Officer, United States Department of Justice.
[FR Doc. 97-7581 Filed 3-25-97; 8:45 am]
BILLING CODE 4410-20-M