I 

112TH CONGRESS 

1ST SESSION H. R. 173 

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. 

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 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. 

4 This Act may be cited as the ‘‘Medicare Fraud Pre5 vention Act of 2011’’. 


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•HR 173 IH

1 SEC. 2. INCREASED CIVIL MONEY PENALTIES AND CRIMI2 NAL FINES FOR MEDICARE FRAUD AND 

3 ABUSE. 

4 (a) INCREASED CIVIL MONEY PENALTIES.—Section 

5 1128A of the Social Security Act (42 U.S.C. 1320a–7a) 

6 is amended— 

7 (1) in subsection (a), in the flush matter fol8 lowing paragraph (10)— 

9 (A) by striking ‘‘$10,000’’ each place it 

10 appears and inserting ‘‘$20,000’’; 

11 (B) by striking ‘‘$15,000’’ and inserting 

12 ‘‘$30,000’’; and 

13 (C) by striking ‘‘$50,000’’ each place it ap14 pears and inserting ‘‘$100,000’’; and øBrack15 eted addition made to account for amendments 

16 made by PPPACA PL111–148. Please review to 

17 be sure that addition reflects policy intent.¿ 

18 (2) in subsection (b)— 

19 (A) in paragraph (1), in the flush matter 

20 following subparagraph (B), by striking 

21 ‘‘$2,000’’ and inserting ‘‘$4,000’’; 

22 (B) in paragraph (2), by striking ‘‘$2,000’’ 

23 and inserting ‘‘$4,000’’; and 

24 (C) in paragraph (3)(A)(i), by striking 

25 ‘‘$5,000’’ and inserting ‘‘$10,000’’. 


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•HR 173 IH

1 (b) INCREASED CRIMINAL FINES.—Section 1128B of 

2 the Social Security Act (42 U.S.C. 1320a–7b) is amend3 ed— 

4 (1) in subsection (a), in the flush matter fol5 lowing paragraph (6)— 

6 (A) by striking ‘‘$25,000’’ and inserting 

7 ‘‘$100,000’’; and 

8 (B) by striking ‘‘$10,000’’ and inserting 

9 ‘‘$20,000’’; 

10 (2) in subsection (b)— 

11 (A) in paragraph (1), in the flush matter 

12 following subparagraph (B), by striking 

13 ‘‘$25,000’’ and inserting ‘‘$100,000’’; and 

14 (B) in paragraph (2), in the flush matter 

15 following subparagraph (B), by striking 

16 ‘‘$25,000’’ and inserting ‘‘$100,000’’; 

17 (3) in subsection (c), by striking ‘‘$25,000’’ and 

18 inserting ‘‘$100,000’’; 

19 (4) in subsection (d), in the second flush matter 

20 following subparagraph (B), by striking ‘‘$25,000’’ 

21 and inserting ‘‘$100,000’’; and 

22 (5) in subsection (e), by striking ‘‘$2,000’’ and 

23 inserting ‘‘$4,000’’. 

24 (c) EFFECTIVE DATE.—The amendments made by 

25 this section shall apply to civil money penalties and fines 


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•HR 173 IH

1 imposed for actions taken on or after the date of enact2 ment of this Act. 

3 SEC. 3. INCREASED SENTENCES FOR FELONIES INVOLVING 

4 MEDICARE FRAUD AND ABUSE. 

5 (a) FALSE STATEMENTS AND REPRESENTATIONS.— 

6 Section 1128B(a) of the Social Security Act (42 U.S.C. 

7 1320a–7b(a)) is amended, in clause (i) of the flush matter 

8 following paragraph (6), by striking ‘‘not more than five 

9 years’’ and inserting ‘‘not more than 10 years’’. 

10 (b) ANTI-KICKBACK.—Section 1128B(b) of the So11 cial Security Act (42 U.S.C. 1320a–7b(b)) is amended— 

12 (1) in paragraph (1), in the flush matter fol13 lowing subparagraph (B), by striking ‘‘not more 

14 than five years’’ and inserting ‘‘not more than 10 

15 years’’; and 

16 (2) in paragraph (2), in the flush matter fol17 lowing subparagraph (B), by striking ‘‘not more 

18 than five years’’ and inserting ‘‘not more than 10 

19 years’’. 

20 (c) FALSE STATEMENT OR REPRESENTATION WITH

21 RESPECT TO CONDITIONS OR OPERATIONS OF FACILI22 TIES.—Section 1128B(c) of the Social Security Act (42 

23 U.S.C. 1320a–7b(c)) is amended by striking ‘‘not more 

24 than five years’’ and inserting ‘‘not more than 10 years’’. 


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•HR 173 IH

1 (d) EXCESS CHARGES.—Section 1128B(d) of the So2 cial Security Act (42 U.S.C. 1320a–7b(d)) is amended, in 

3 the second flush matter following subparagraph (B), by 

4 striking ‘‘not more than five years’’ and inserting ‘‘not 

5 more than 10 years’’. 

6 (e) EFFECTIVE DATE.—The amendments made by 

7 this section shall apply to criminal penalties imposed for 

8 actions taken on or after the date of enactment of this 

9 Act. 

10 SEC. 4. INCREASED SURETY BOND REQUIREMENT FOR SUP11 PLIERS OF DME. 

12 (a) IN GENERAL.—Section 1834(a)(16)(B) of the So13 cial Security Act (42 U.S.C. 1395m(a)(16)(B)) is amend14 ed by striking ‘‘$50,000’’ and inserting ‘‘$500,000’’. 

15 (b) EFFECTIVE DATE.—The amendment made by 

16 this section shall apply to the issuance (or renewal) of a 

17 provider number for a supplier of durable medical equip18 ment on or after the date of enactment of this Act. 

Æ 


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