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Subtitle B—Coordination of Health
Care Anti-Fraud and Abuse Ac-
tivities
SEC. 711. APPLICATION OF FEDERAL HEALTH ANTI-FRAUD
AND ABUSE SANCTIONS TO ALL FRAUD AND
ABUSE AGAINST ANY HEALTH INSURANCE
PLAN.
(a) CIVIL MONETARY PENALTIES.—Section 1128A
of the Social Security Act (42 U.S.C. 1320a–7a) is amend-
ed as follows:
(1) In subsection (a)(1), in the matter before
subparagraph (A), by inserting ‘‘or of any health in-
surance plan,’’ after ‘‘subsection (i)(1)),’’.
(2) In subsection (b)(1)(A), by inserting ‘‘or
under a health insurance plan’’ after ‘‘title XIX’’.
(3) In subsection (f)—
(A) by redesignating paragraph (3) as
paragraph (4); and
(B) by inserting after paragraph (2) the
following new paragraph:
‘‘(3) With respect to amounts recovered arising
out of a claim under a health insurance plan, the
portion of such amounts as is determined to have
been paid by the plan shall be repaid to the plan.’’.
(4) In subsection (i)—
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(A) in paragraph (2), by inserting ‘‘or
under a health insurance plan’’ before the pe-
riod at the end, and
(B) in paragraph (5), by inserting ‘‘or
under a health insurance plan’’ after ‘‘or XX’’.
(b) CRIMES.—
(1) SOCIAL SECURITY ACT.—Section 1128B of
such Act (42 U.S.C. 1320a–7b) is amended as
follows:
(A) In the heading, by adding at the end
the following: ‘‘OR HEALTH INSURANCE PLANS’’.
(B) In subsection (a)(1)—
(i) by striking ‘‘title XVIII or’’ and
inserting ‘‘title XVIII,’’, and
(ii) by adding at the end the follow-
ing: ‘‘or a health insurance plan (as de-
fined in section 1128(i)),’’.
(C) In subsection (a)(5), by striking ‘‘title
XVIII or a State health care program’’ and in-
serting ‘‘title XVIII, a State health care pro-
gram, or a health insurance plan’’.
(D) In the second sentence of subsection
(a)—
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(i) by inserting after ‘‘title XIX’’ the
following: ‘‘or a health insurance plan’’,
and
(ii) by inserting after ‘‘the State’’ the
following: ‘‘or the plan’’.
(E) In subsection (b)(1), by striking ‘‘title
XVIII or a State health care program’’ each
place it appears and inserting ‘‘title XVIII, a
State health care program, or a health insur-
ance plan’’.
(F) In subsection (b)(2), by striking ‘‘title
XVIII or a State health care program’’ each
place it appears and inserting ‘‘title XVIII, a
State health care program, or a health insur-
ance plan’’.
(G) In subsection (b)(3), by striking ‘‘title
XVIII or a State health care program’’ each
place it appears in subparagraphs (A) and (C)
and inserting ‘‘title XVIII, a State health care
program, or a health insurance plan’’.
(H) In subsection (d)(2)—
(i) by striking ‘‘title XIX,’’ and insert-
ing ‘‘title XIX or under a health insurance
plan,’’, and
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(ii) by striking ‘‘State plan,’’ and in-
serting ‘‘State plan or the health insurance
plan,’’.
(2) TREBLE
DAMAGES
FOR
CRIMINAL
SANC-
TIONS.—Section 1128B of such Act (42 U.S.C.
1320a–7b) is amended by adding at the end the fol-
lowing new subsection:
‘‘(f) In addition to the fines that may be imposed
under subsection (a), (b), or (c), any individual found to
have violated the provisions of any of such subsections
may be subject to treble damages.’’.
(3) IDENTIFICATION OF COMMUNITY SERVICE
OPPORTUNITIES.—Section 1128B of such Act (42
U.S.C. 1320a–7b) is further amended by adding at
the end the following new subsection:
‘‘(g) The Secretary shall—
‘‘(1) in consultation with State and local health
care officials, identify opportunities for the satisfac-
tion of community service obligations that a court
may impose upon the conviction of an offense under
this section, and
‘‘(2) make information concerning such oppor-
tunities available to Federal and State law enforce-
ment officers and State and local health care offi-
cials.’’.
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(c) HEALTH INSURANCE PLAN DEFINED.—Section
1128 of such Act (42 U.S.C. 1320a–7) is amended by re-
designating subsection (i) as subsection (j) and by insert-
ing after subsection (h) the following new subsection:
‘‘(i) HEALTH INSURANCE PLAN DEFINED.—For pur-
poses of sections 1128A and 1128B, the term ‘health in-
surance plan’ means a health insurance program other
than the medicare program, the medicaid program, or a
State health care program.’’.
(d) 
CONFORMING
AMENDMENT.—Section
1128(b)(8)(B)(ii) of such Act (42 U.S.C. 1320a–
7(b)(8)(B)(ii)) is amended by striking ‘‘1128A’’ and in-
serting ‘‘1128A (other than a penalty arising from a
health insurance plan, as defined in subsection (i))’’.
(e) EFFECTIVE DATE.—The amendments made by
this section shall take effect January 1, 1995.
Subtitle C—Protection Against
Rationing of Treatment
SEC. 721. PROHIBITION ON DENIAL OR TREATMENT BASED
ON AGE, DISABILITY, DEGREE OF MEDICAL
NEED, OR QUALITY OF LIFE.
No health care provider or health insurance plan may
deny medical treatment, or insurance coverage of medical
treatment, that a patient is otherwise qualified to receive,
against the wishes of a patient, or if the patient is incom-
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petent, against the wishes of the patient’s guardian, on
the basis of the patient’s present or predicted age, disabil-
ity, degree of medical need, or quality of life.
SEC. 722. ENFORCEMENT.
The remedies and procedures set forth in subsections
(a) and (b) of Civil Rights Act of 1964 (42 U.S.C. 2000a–
3) are the remedies and procedures available under this
subtitle to nay person who is being subjected to denial of
medical treatment or denial of insurance coverage for
medical treatment, or who has reasonable grounds for be-
lieving that such person is about to be subjected to such
denial, in violation of this subtitle. A person who has been
subjected to such denial in violation of this subtitle, or
if that person has died, a person who would be entitled
to bring a cause of action for the dead person’s wrongful
death under the laws of the State in which the denial of
treatment occurred, may also obtain damages, including
reasonable and appropriate punitive damages.
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