I 
113TH CONGRESS 
1ST SESSION H. R. 3776 
To amend title XVIII of the Social Security Act to create alternative sanctions 
for technical noncompliance with the Stark rule under Medicare, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 16, 2013 
Mr. BOUSTANY (for himself, Mr. KIND, Mr. BUCSHON, and Mr. VEASEY) in-
troduced the following bill; which was referred to the Committee on En-
ergy 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 jurisdic-
tion of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to create 
alternative sanctions for technical noncompliance with 
the Stark rule under Medicare, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Stark Administrative 
Simplification Act’’. 
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SEC. 2. ALTERNATIVE SANCTIONS FOR TECHNICAL NON-
COMPLIANCE 
WITH 
STARK 
RULE 
UNDER 
MEDICARE. 
Section 1877(g) of the Social Security Act (42 U.S.C. 
1395nn(g)) is amended— 
(1) in paragraph (1), by striking ‘‘No’’ and in-
serting ‘‘Subject to paragraph (7), no’’; 
(2) in paragraph (2), by striking ‘‘If’’ and in-
serting ‘‘Subject to paragraph (7), if’’; 
(3) in paragraph (3), by striking ‘‘Any’’ and in-
serting ‘‘Subject to paragraph (7), any’’; and 
(4) by adding at the end the following new 
paragraph: 
‘‘(7) ALTERNATIVE SANCTIONS FOR TECHNICAL 
NONCOMPLIANCE.— 
‘‘(A) SINGLE
PENALTY
FOR
COMPENSA-
TION
ARRANGEMENTS
IN
TECHNICAL
NON-
COMPLIANCE.—In the case of a compensation 
arrangement between a physician (or an imme-
diate family member of such physician) and a 
person or entity that is in violation of sub-
section (a)(1) solely due to technical noncompli-
ance, instead of the sanctions described in para-
graphs (1), (2), and (3) for any such violation, 
the person or entity with respect to such ar-
rangement shall be subject to a single civil mon-
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etary penalty under this paragraph in an 
amount that does not exceed— 
‘‘(i) in the case where the disclosure 
of the violation is submitted to the Sec-
retary not later than the date that is one 
year after the initial date of noncompli-
ance, $5,000; and 
‘‘(ii) in the case where the disclosure 
of the violation is submitted to the Sec-
retary after the date that is one year after 
the initial date of noncompliance, $10,000. 
‘‘(B) ACCEPTANCE
OF
VOLUNTARY
DIS-
CLOSURES.— 
‘‘(i) IN
GENERAL.—Effective on the 
date of the enactment of this paragraph, 
the Secretary shall accept the voluntary 
disclosure of a technically noncompliant 
compensation arrangement if such vol-
untary disclosure is made as described in 
clause (iii). The Secretary may accept and 
reasonably rely on information provided by 
a person or entity that is in violation of 
subsection (a)(1) only because of a com-
pensation arrangement that is technically 
noncompliant. 
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‘‘(ii) ACCEPTANCE OF DISCLOSURE.— 
The Secretary may reject any voluntary 
disclosure submitted under clause (iii) 
within 90 days after the receipt of the dis-
closure only if the Secretary determines 
that the disclosure does not conform to the 
requirements described in clause (iii). If 
the Secretary fails to reject a voluntary 
disclosure within such 90-day period, the 
voluntary disclosure is deemed to be ac-
cepted. 
‘‘(iii) VOLUNTARY
DISCLOSURE.—A 
voluntary disclosure described in this 
clause, with respect to a compensation ar-
rangement, is a disclosure submitted to the 
Secretary, by a party to such arrangement 
that contains the following: 
‘‘(I) The identification of the dis-
closing party and all other parties to 
the disclosed compensation arrange-
ment. 
‘‘(II) A description of the com-
pensation paid under the arrangement 
and the dates of noncompliance. 
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‘‘(III) A certification by the dis-
closing party that the compensation 
arrangement— 
‘‘(aa) is technically non-
compliant (as defined by sub-
paragraph (C)); 
‘‘(bb) has been cured of the 
technical noncompliance, or is 
otherwise terminated; and 
‘‘(cc) is, in the case of tech-
nical noncompliance under sub-
paragraph (C)(i), a valid contract 
under State law, an arrangement 
consistent with fair market value, 
and one in which remuneration 
under the arrangement is not de-
termined in a manner that takes 
into account directly or indirectly 
the volume or value of any refer-
rals. 
‘‘(IV) 
Payment 
for 
the 
full 
amount of the civil monetary penalty 
under clause (i) or (ii), as applicable, 
of subparagraph (A). 
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‘‘(C) DEFINITION TECHNICAL NONCOMPLI-
ANCE.—For purposes of this paragraph, the 
term ‘technical noncompliance’ means an ar-
rangement that is in violation of subsection 
(a)(1) only because— 
‘‘(i) the arrangement is not set forth 
in writing; 
‘‘(ii) the arrangement is not signed by 
1 or more parties to the arrangement; or 
‘‘(iii) a prior arrangement expired and 
services continued without the execution of 
an amendment to such arrangement or a 
new arrangement. 
‘‘(D) APPLICABILITY TO PRE-ENACTMENT 
DISCLOSURES TO RELIEVE BACKLOG.—The Sec-
retary shall provide for the application of this 
paragraph to any technically noncompliant com-
pensation arrangement that has been disclosed, 
and to which there has not been a final settle-
ment as of the date of enactment of this para-
graph. 
‘‘(E) REPORT.—Not later than 24 months 
after the date of enactment of this paragraph, 
the Inspector General of the Department of 
Health and Human Services shall submit to 
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Congress a report on the implementation of this 
paragraph. Such report shall include— 
‘‘(i) the number of persons or entities 
making disclosures of technical noncompli-
ance under this paragraph; 
‘‘(ii) the amount and type of alter-
native sanctions collected or imposed for 
technical noncompliance; 
‘‘(iii) the types of violations disclosed; 
and 
‘‘(iv) such other information as the 
Inspector General determines may be nec-
essary to evaluate the impact of this para-
graph.’’. 
Æ 
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