I 

113TH CONGRESS 

1ST SESSION H. R. 2925 

To amend title XI of the Social Security Act to expand the permissive 

exclusion from participation in Federal health care programs to individuals and entities affiliated with sanctioned entities. 

IN THE HOUSE OF REPRESENTATIVES 

AUGUST 1, 2013 

Mr. BRADY of Texas (for himself, Mr. MCDERMOTT, Mr. BUCHANAN, Mr. 

GERLACH, Mr. KIND, Mr. LEVIN, Mr. BLUMENAUER, Mr. LARSON of 

Connecticut, Mrs. BLACK, Mr. DOGGETT, Mr. KELLY of Pennsylvania, 

Mr. BOUSTANY, Mr. LEWIS, Mr. NUNES, Mr. GRIFFIN of Arkansas, Mr. 

SMITH of Nebraska, Mr. SCHOCK, Mr. REICHERT, Mr. SAM JOHNSON of 

Texas, Mr. REED, Mr. PAULSEN, Ms. JENKINS, Mr. RENACCI, Mr. 

LIPINSKI, and Mr. VAN HOLLEN) introduced the following bill; which was 

referred to the Committee on Energy and Commerce, and in addition to 

the Committee on Ways and Means, 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 title XI of the Social Security Act to expand 

the permissive exclusion from participation in Federal 

health care programs to individuals and entities affiliated 

with sanctioned entities. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Strengthening Medi3 care Anti-Fraud Measures Act of 2013’’. 

4 SEC. 2. PERMISSIVE EXCLUSION FROM FEDERAL HEALTH 

5 CARE PROGRAMS EXPANDED TO INDIVID6 UALS AND ENTITIES AFFILIATED WITH SANC7 TIONED ENTITIES. 

8 Section 1128(b)(15) of the Social Security Act (42 

9 U.S.C. 1320a–7(b)(15)) is amended to read as follows: 

10 ‘‘(15) INDIVIDUALS OR ENTITIES AFFILIATED

11 WITH A SANCTIONED ENTITY.—(A) Any of the fol12 lowing: 

13 ‘‘(i) Any individual who— 

14 ‘‘(I) is a person with an ownership or 

15 control interest (as defined in section 

16 1124(a)(3)) in a sanctioned entity or an 

17 affiliated entity of such sanctioned entity 

18 (or was a person with such an interest at 

19 the time of any of the conduct that formed 

20 a basis for the conviction or exclusion de21 scribed in subparagraph (B)); and 

22 ‘‘(II) knows or should know (as de23 fined in section 1128A(i)(7)) (or knew or 

24 should have known) of such conduct. 

25 ‘‘(ii) Any individual who is an officer or 

26 managing employee (as defined in section 


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1 1126(b)) of a sanctioned entity or affiliated en2 tity of such sanctioned entity (or was such an 

3 officer or managing employee at the time of any 

4 of the conduct that formed a basis for the con5 viction or exclusion described in subparagraph 

6 (B)). 

7 ‘‘(iii) Any affiliated entity of a sanctioned 

8 entity. 

9 ‘‘(B) For purposes of this paragraph, the term 

10 ‘sanctioned entity’ means an entity— 

11 ‘‘(i) that has been convicted of any offense 

12 described in subsection (a) or in paragraph (1), 

13 (2), or (3) of this subsection; or 

14 ‘‘(ii) that has been excluded from partici15 pation under a program under title XVIII or 

16 under a State health care program. 

17 ‘‘(C)(i) For purposes of this paragraph, the 

18 term ‘affiliated entity’ means, with respect to a 

19 sanctioned entity— 

20 ‘‘(I) an entity affiliated with such sanc21 tioned entity; and 

22 ‘‘(II) an entity that was so affiliated at the 

23 time of any of the conduct that formed the 

24 basis for the conviction or exclusion described 

25 in subparagraph (B). 


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1 ‘‘(ii) For purposes of clause (i), an entity 

2 shall be treated as affiliated with another entity 

3 if— 

4 ‘‘(I) one of the entities is a person 

5 with an ownership or control interest (as 

6 defined in section 1124(a)(3)) in the other 

7 entity (or had such an interest at the time 

8 of any of the conduct that formed a basis 

9 for the conviction or exclusion described in 

10 subparagraph (B)); 

11 ‘‘(II) there is a person with an owner12 ship or control interest (as defined in sec13 tion 1124(a)(3)) in both entities (or had 

14 such an interest at the time of any of the 

15 conduct that formed a basis for the convic16 tion or exclusion described in subpara17 graph (B)); or 

18 ‘‘(III) there is a person who is an offi19 cer or managing employee (as defined in 

20 section 1126(b)) of both entities (or was 

21 such an officer or managing employee at 

22 the time of any of the conduct that formed 

23 a basis for the conviction or exclusion de24 scribed in subparagraph (B)).’’. 

Æ 


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