Strengthening Medicare Anti-Fraud Measures Act of 2013

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. Short title This Act may be cited as the Strengthening Medicare Anti-Fraud Measures Act of 2013 2. Permissive exclusion from Federal health care programs expanded to individuals and entities affiliated with sanctioned entities Section 1128(b)(15) of the Social Security Act ( 42 U.S.C. 1320a–7(b)(15) (15) Individuals or entities affiliated with a sanctioned entity (A) Any of the following: (i) Any individual who— (I) is a person with an ownership or control interest (as defined in section 1124(a)(3)) in a sanctioned entity or an affiliated entity of such sanctioned entity (or was a person with such an interest at the time of any of the conduct that formed a basis for the conviction or exclusion described in subparagraph (B)); and (II) knows or should know (as defined in section 1128A(i)(7)) (or knew or should have known) of such conduct. (ii) Any individual who is an officer or managing employee (as defined in section 1126(b)) of a sanctioned entity or affiliated entity of such sanctioned entity (or was such an officer or managing employee at the time of any of the conduct that formed a basis for the conviction or exclusion described in subparagraph (B)). (iii) Any affiliated entity of a sanctioned entity. (B) For purposes of this paragraph, the term sanctioned entity (i) that has been convicted of any offense described in subsection (a) or in paragraph (1), (2), or (3) of this subsection; or (ii) that has been excluded from participation under a program under title XVIII or under a State health care program. (C) (i) For purposes of this paragraph, the term affiliated entity (I) an entity affiliated with such sanctioned entity; and (II) an entity that was so affiliated at the time of any of the conduct that formed the basis for the conviction or exclusion described in subparagraph (B). (ii) For purposes of clause (i), an entity shall be treated as affiliated with another entity if— (I) one of the entities is a person with an ownership or control interest (as defined in section 1124(a)(3)) in the other entity (or had such an interest at the time of any of the conduct that formed a basis for the conviction or exclusion described in subparagraph (B)); (II) there is a person with an ownership or control interest (as defined in section 1124(a)(3)) in both entities (or had such an interest at the time of any of the conduct that formed a basis for the conviction or exclusion described in subparagraph (B)); or (III) there is a person who is an officer or managing employee (as defined in section 1126(b)) of both entities (or was such an officer or managing employee at the time of any of the conduct that formed a basis for the conviction or exclusion described in subparagraph (B)). .

Summary: Strengthening Medicare Anti-Fraud Measures Act of 2013 - Amends title XI of the Social Security Act to authorize the Secretary of Health and Human Services (HHS) to exclude from participation in any federal health care program entities affiliated with a sanctioned entity, as well as any officer or managing employee of an affiliated entity (currently, only individuals with an ownership or control interest in a sanctioned entity), if the affiliated entity was so affiliated at the time of any of the conduct forming the basis for the conviction or exclusion of the sanctioned entity.