II

103D CONGRESS

2D SESSION S. 1947

To increase criminal penalties for health care fraud, and for other purposes.

IN THE SENATE OF THE UNITED STATES

MARCH 17 (legislative day, FEBRUARY 22), 1994

Mr. KOHL introduced the following bill; which was read twice and referred to

the Committee on the Judiciary

A BILL

To increase criminal penalties for 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.

4 This Act may be cited as the ‘‘Health Care Anti5 Fraud Act of 1994’’.

6 SEC. 2. CRIMINAL PENALTIES FOR HEALTH CARE FRAUD.

7 (a) OFFENSE.—Part I of title 18, United States

8 Code, is amended by inserting after chapter 50A the fol9 lowing:
2

•S 1947 IS

1 ‘‘CHAPTER 50B—HEALTH CARE FRAUD

‘‘Sec.

‘‘1101. Health care fraud.

‘‘1102. Definitions.

2 ‘‘§ 1101. Health care fraud

3 ‘‘(a) IN GENERAL.—Whoever, in or affecting inter4 state commerce, knowingly—

5 ‘‘(1) executes, or attempts to execute, a scheme

6 or artifice to defraud to obtain a health care pay7 ment; or

8 ‘‘(2) presents to any person any statement as

9 part of, or in support of, a claim for a health care

10 payment, knowing that such statement contains any

11 false or misleading information concerning any fact

12 or thing material to such claim;

13 shall be fined under this title or imprisoned not more than

14 10 years, or both.

15 ‘‘(b) AGGRAVATED OFFENSES.—In an offense under

16 subsection (a) of this section—

17 ‘‘(1) if the offender knowingly or recklessly

18 causes serious bodily injury to an individual or

19 knowingly or recklessly endangers the life of a per20 son, the offender shall be fined under this title or

21 imprisoned not more than 15 years, or both; and

22 ‘‘(2) if the offender knowingly or recklessly

23 causes the death of an individual, the offender shall
3

•S 1947 IS

1 be fined under this title or imprisoned not more

2 than 25 years, or both.

3 ‘‘§ 1102. Definitions

4 ‘‘As used in this chapter—

5 ‘‘(1) the term ‘health care payment’ means a

6 payment for health care services or health care prod7 ucts, or the right to have a payment made by a third

8 party payer for specified health care services or

9 products; and

10 ‘‘(2) the term ‘third party payer’ means any

11 person, public or private, who undertakes to indem12 nify another against loss arising from a contingent

13 or unknown event.’’.

14 (b) CLERICAL AMENDMENT.—The table of chapters

15 at the beginning of part I of title 18, United States Code,

16 is amended by inserting after the item relating to chapter

17 50A the following new item:

‘‘50B. Health care fraud .................................................................. 1101.’’.

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

19 this section shall take effect January 1, 1995.

20 SEC. 3. IDENTIFICATION OF COMMUNITY SERVICE OPPOR21 TUNITIES.

22 (a) IN GENERAL.—Chapter 50B of title 18, United

23 States Code, as added by section 2, is amended by insert24 ing after section 1102 the following new section:
4

•S 1947 IS

1 ‘‘§ 1103. Indentification of community service oppor2 tunities

3 ‘‘The Attorney General shall—

4 ‘‘(1) in consultation with the Secretary of

5 Health and Human Services and State and local

6 health care officials, identify opportunities for the

7 satisfaction of community service obligations that a

8 court may impose upon the conviction of an offense

9 under section 1101 or an offense under section

10 1128B of the Social Security Act (42 U.S.C. 1320a–

11 7b), and

12 ‘‘(2) make information concerning such oppor13 tunities available to Federal and State law enforce14 ment officers and State and local health care offi15 cials.’’.

16 (b) CLERICAL AMENDMENT.—The table of sections

17 for such chapter 50B is amended by adding at the end

18 the following new item:

‘‘1103. Identification of community service opportunities.’’.

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

20 this section shall take effect on January 1, 1995.

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