II

105TH CONGRESS

2D SESSION S. 2040

To amend title XIX of the Social Security Act to extend the authority

of State medicaid fraud control units to investigate and prosecute fraud

in connection with Federal health care programs and abuse of residents

of board and care facilities.

IN THE SENATE OF THE UNITED STATES

MAY 7, 1998

Mr. BAUCUS (for himself, Mr. GRAHAM, Mr. BREAUX, Mr. REID, Mr. GRASSLEY, Ms. MIKULSKI, and Mr. JOHNSON) introduced the following bill;

which was read twice and referred to the Committee on Finance

A BILL

To amend title XIX of the Social Security Act to extend

the authority of State medicaid fraud control units to

investigate and prosecute fraud in connection with Federal health care programs and abuse of residents of

board and care facilities.

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 ‘‘Senior Citizen Protec5 tion Act of 1998’’.
2

•S 2040 IS

1 SEC. 2. EXTENSION OF AUTHORITY OF STATE MEDICAID

2 FRAUD CONTROL UNITS.

3 (a) EXTENSION OF CONCURRENT AUTHORITY TO IN4 VESTIGATE AND PROSECUTE FRAUD IN OTHER FEDERAL

5 HEALTH CARE PROGRAMS.—Section 1903(q)(3) of the

6 Social Security Act (42 U.S.C. 1396b(q)(3)) is amended—

7 (1) by inserting ‘‘(A)’’ after ‘‘in connection

8 with’’; and

9 (2) by striking ‘‘title.’’ and inserting ‘‘title; and

10 (B) upon the approval of the Inspector General of

11 the relevant Federal agency, any aspect of the provi12 sion of health care services and activities of provid13 ers of such services under any Federal health care

14 program (as defined in section 1128B(f)(1)), if the

15 suspected fraud or violation of law is primarily relat16 ed to the State plan under this title.’’.

17 (b) RECOUPMENT OF FUNDS.—Section 1903(q)(5) of

18 such Act (42 U.S.C. 1396b(q)(5)) is amended—

19 (1) by inserting ‘‘or under any Federal health

20 care program (as so defined)’’ after ‘‘plan’’; and

21 (2) by adding at the end the following: ‘‘Funds

22 collected in accordance with this paragraph shall be

23 credited to, and available for expenditure under, the

24 Federal health care program (including the State

25 plan under this title) that was subject to the activity

26 that was the basis for the collection.’’.
3

•S 2040 IS

1 (c) EXTENSION OF AUTHORITY TO INVESTIGATE

2 AND PROSECUTE RESIDENT ABUSE IN NON-MEDICAID

3 BOARD AND CARE FACILITIES.—Section 1903(q)(4) of

4 such Act (42 U.S.C. 1396b(q)(4)) is amended to read as

5 follows:

6 ‘‘(4)(A) The entity has—

7 ‘‘(i) procedures for reviewing complaints of

8 abuse or neglect of patients in health care fa9 cilities which receive payments under the State

10 plan under this title;

11 ‘‘(ii) at the option of the entity, procedures

12 for reviewing complaints of abuse or neglect of

13 patients residing in board and care facilities;

14 and

15 ‘‘(iii) procedures for acting upon such com16 plaints under the criminal laws of the State or

17 for referring such complaints to other State

18 agencies for action.

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

20 ‘board and care facility’ means a residential setting

21 which receives payment (regardless of whether such

22 payment is made under the State plan under this

23 title) from or on behalf of two or more unrelated

24 adults who reside in such facility, and for whom one

25 or both of the following is provided:
4

•S 2040 IS

1 ‘‘(i) Nursing care services provided by, or

2 under the supervision of, a registered nurse, li3 censed practical nurse, or licensed nursing as4 sistant.

5 ‘‘(ii) A substantial amount of personal care

6 services that assist residents with the activities

7 of daily living, including personal hygiene,

8 dressing, bathing, eating, toileting, ambulation,

9 transfer, positioning, self-medication, body care,

10 travel to medical services, essential shopping,

11 meal preparation, laundry, and housework.’’.

12 (d) EFFECTIVE DATE.—The amendments made by

13 this section take effect on the date of enactment of this

14 Act.

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