II 

113TH CONGRESS 

2D SESSION S. 1944 

To amend title XVIII of the Social Security Act to distribute additional 

information to Medicare beneficiaries to prevent health care fraud, and 

for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 16, 2014 

Mrs. SHAHEEN (for herself and Mr. CASEY) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to distribute 

additional information to Medicare beneficiaries to prevent health care fraud, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; FINDINGS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Protecting Seniors from Health Care Fraud Act of 

6 2014’’. 

7 (b) FINDINGS.—Congress finds the following: 

8 (1) Seniors are more vulnerable to fraud than 

9 the general population. 


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1 (2) Because seniors require more health care 

2 services than the general population, they need more 

3 information on health care schemes so they can pro4 tect themselves. 

5 (3) The Department of Health and Human 

6 Services should provide more up-to-date information 

7 in order to educate seniors on health care scams. 

8 SEC. 2. DISTRIBUTION OF ADDITIONAL INFORMATION TO 

9 SENIORS TO PREVENT HEALTH CARE FRAUD. 

10 Section 1804 of the Social Security Act (42 U.S.C. 

11 1395b–2) is amended by adding at the end the following 

12 new subsection: 

13 ‘‘(d) DISTRIBUTION OF ADDITIONAL INFORMATION

14 ON HEALTH CARE FRAUD.— 

15 ‘‘(1) ANNUAL REPORTS ON HEALTH CARE

16 FRAUD SCHEMES.— 

17 ‘‘(A) IN GENERAL.—In connection with the 

18 Health Care Fraud and Abuse Control Program 

19 established under section 1128C, the Secretary, 

20 acting through the Office of the Inspector Gen21 eral of the Department of Health and Human 

22 Services, and the Attorney General, shall trans23 mit to Congress, and make available to the pub24 lic, an annual report on health care fraud 

25 schemes that are targeted to seniors and steps 


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1 that are being taken to combat such schemes 

2 and to educate seniors concerning such 

3 schemes. The first such report shall be trans4 mitted and made available not later than 2 

5 years after the date of the enactment of this 

6 subsection. 

7 ‘‘(B) CONTENTS OF REPORTS.— 

8 ‘‘(i) IN GENERAL.—Subject to clause 

9 (ii), each annual report under subpara10 graph (A) shall include the following infor11 mation: 

12 ‘‘(I) IDENTIFICATION OF MOST

13 PREVALENT FRAUD SCHEMES.—The 

14 identification of the 10 most prevalent 

15 health care fraud schemes that are 

16 targeted to seniors and the prevalence 

17 and trends in such schemes. 

18 ‘‘(II) PROTECTION OF SEN19 IORS.—Actions that seniors and law 

20 enforcement and government agencies 

21 are taking and can take to combat 

22 such schemes and to protect seniors 

23 against health care fraud schemes. 

24 ‘‘(III) ADDITIONAL SUGGES25 TIONS.—Policy suggestions to improve 


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1 protections for seniors, including 

2 whether the additional information 

3 provided under this subsection is help4 ing seniors in protecting them against 

5 fraud. 

6 ‘‘(ii) LIMITATIONS.—The Secretary 

7 may— 

8 ‘‘(I) omit information from an 

9 annual report on fraud schemes tar10 geting seniors if public disclosure of 

11 the information would compromise an 

12 ongoing investigation; and 

13 ‘‘(II) report information on fraud 

14 schemes by categories in an annual 

15 report if a more detailed disclosure of 

16 such a scheme would educate crimi17 nals rather than seniors. 

18 ‘‘(iii) PRIVATE-PUBLIC PARTNER19 SHIP.—The Secretary, acting through the 

20 Office of the Inspector General of the De21 partment of Health and Human Services 

22 and the Attorney General, may enter into 

23 an arrangement between public and private 

24 partners to develop the report that identi25 fies the top 10 most prevalent health care 


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1 fraud schemes and the associated report 

2 information. 

3 ‘‘(C) QUARTERLY UPDATING.—The infor4 mation described in clauses (i) and (iii) of sub5 paragraph (B) shall be updated quarterly to re6 flect changes in fraud schemes and methods to 

7 combat and educate seniors concerning such 

8 schemes. 

9 ‘‘(D) LANGUAGES.—Such reports, as up10 dated, shall be available in English and Span11 ish. 

12 ‘‘(2) DISSEMINATION OF REPORTS AND TOP 10

13 LIST.— 

14 ‘‘(A) IN GENERAL.—The Secretary shall— 

15 ‘‘(i) disseminate the reports under 

16 paragraph (1) to Medicare beneficiaries 

17 through mechanisms that reach the most 

18 Medicare beneficiaries; and 

19 ‘‘(ii) provide for the mailing to each 

20 Medicare beneficiary of a list of the top 10 

21 most prevalent health care fraud schemes. 

22 ‘‘(B) QUARTERLY UPDATES OF TOP 10

23 LIST INCLUDED WITH MEDICARE SUMMARY NO24 TICES.—The Secretary shall include an updated 

25 list of the top 10 most prevalent health care 


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1 fraud schemes under paragraph (1)(C) with the 

2 quarterly Medicare summary notices mailed to 

3 Medicare beneficiaries. 

4 ‘‘(C) POSTING OF REPORTS AND QUAR5 TERLY UPDATES ON WEBSITES.—The annual 

6 reports, and quarterly updates, under this sub7 section shall be posted on the website of the 

8 Health Care Fraud and Abuse Control Program 

9 and on other websites maintained or supported 

10 by the Secretary relating to the Medicare pro11 gram, the State Health Insurance Assistance 

12 Program, and the Senior Medicare Patrol of the 

13 Administration on Aging. 

14 ‘‘(3) SOURCES OF INFORMATION FOR RE15 PORTS.—Information for the reports and updates 

16 under paragraph (1) shall be gathered from at least 

17 the following sources: 

18 ‘‘(A) DEPARTMENT OF HEALTH AND

19 HUMAN SERVICES.—The following sources with20 in the Department of Health and Human Serv21 ices: 

22 ‘‘(i) Medicare hotlines, including 1– 

23 800–MEDICARE, 1–800–HHSTIPS, and 

24 Medicare fraud toll-free hotlines and 

25 websites (such as 


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1 www.stopmedicarefraud.gov) established by 

2 the Office of the Inspector General of the 

3 Department of Health and Human Serv4 ices and the Centers for Medicare & Med5 icaid Services. 

6 ‘‘(ii) State Health Insurance Assist7 ance Programs (SHIPs). 

8 ‘‘(iii) The Administration on Commu9 nity Living, including— 

10 ‘‘(I) the Senior Medicare Patrol 

11 (SMP) of the Administration on 

12 Aging; and 

13 ‘‘(II) Aging and Disability Re14 source Centers. 

15 ‘‘(iv) Medicare administrative contrac16 tors, fiscal intermediaries, and other con17 tractors with the Centers for Medicare & 

18 Medicaid Services performing functions 

19 which may relate to fraud and abuse under 

20 the Medicare program. 

21 ‘‘(v) The Indian Health Service. 

22 ‘‘(B) DEPARTMENT OF JUSTICE.—The De23 partment of Justice, including the Federal Bu24 reau of Investigation. 


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1 ‘‘(C) SSA.—The Social Security Adminis2 tration. 

3 ‘‘(D) FTC.—The Federal Trade Commis4 sion. 

5 ‘‘(E) OPTIONAL ADDITIONAL SOURCES.— 

6 At the option of the Secretary— 

7 ‘‘(i) State agencies that deal with 

8 elder abuse; and 

9 ‘‘(ii) other governmental and non10 governmental entities with expertise in the 

11 protection of seniors from health care 

12 fraud as deemed appropriate.’’. 

Æ 


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