•HR 1200 SC4
(A) IN GENERAL.—Each State Health Se-
curity Advisory Council shall review, and sub-
mit comments to the Governor concerning the
implementation of the State health security pro-
gram in the State.
(B) ASSISTANCE.—Each State Health Se-
curity Advisory Council shall provide assistance
and technical support to community organiza-
tions and public and private non-profit agencies
submitting applications for funding under ap-
propriate State and Federal public health pro-
grams, with particular emphasis placed on as-
sisting those applicants with broad consumer
representation.
(d) STATE USE OF FISCAL AGENTS.—
(1) IN GENERAL.—Each State health security
program, using competitive bidding procedures, may
enter into such contracts with qualified entities, such
as voluntary associations, as the State determines to
be appropriate to process claims and to perform
other related functions of fiscal agents under the
State health security program.
(2) RESTRICTION.—Except as the Board may
provide for good cause shown, in no case may more
•HR 1200 SC4
than one contract described in paragraph (1) be
entered into under a State health security program.
SEC. 
406. 
COMPLEMENTARY 
CONDUCT 
OF 
RELATED
HEALTH PROGRAMS.
In performing functions with respect to health per-
sonnel education and training, health research, environ-
mental health, disability insurance, vocational rehabilita-
tion, the regulation of food and drugs, and all other mat-
ters pertaining to health, the Secretary of Health and
Human Services shall direct all activities of the Depart-
ment of Health and Human Services toward contributions
to the health of the people complementary to this Act.
Subtitle B—Control Over Fraud
and Abuse
SEC. 411. APPLICATION OF FEDERAL SANCTIONS TO ALL
FRAUD 
AND 
ABUSE 
UNDER 
AMERICAN
HEALTH SECURITY PROGRAM.
The following sections of the Social Security Act shall
apply to State health security programs in the same man-
ner as they apply to State medical assistance plans under
title XIX of such Act (except that in applying such provi-
sions any reference to the Secretary is deemed a reference
to the Board):
(1) Section 1128 (relating to exclusion of indi-
viduals and entities).
•HR 1200 SC4
(2) Section 1128A (civil monetary penalties).
(3) Section 1128B (criminal penalties).
(4) Section 1124 (relating to disclosure of own-
ership and related information).
(5) Section 1126 (relating to disclosure of cer-
tain owners).
SEC. 412. NATIONAL HEALTH CARE FRAUD DATA BASE.
(a) ESTABLISHMENT.—The American Health Secu-
rity Standards Board, through the Inspector General,
shall establish a national data base (in this section
referred to as the ‘‘data base’’) containing information
relating to health care fraud and abuse.
(b) DATA INCLUDED.—
(1) IN GENERAL.—The data base shall include
such information as the Inspector General, in con-
sultation with the Board, shall specify, and shall
include at least the information described in
paragraph (2).
(2) SPECIFIED
INFORMATION.—The informa-
tion specified in this paragraph is, with respect to
providers of health care services, the identity of any
provider—
(A) that has been convicted of a crime for
which the provider may be excluded from par-
•HR 1200 SC4
ticipation under a health program (as defined
in paragraph (3));
(B) whose license to provide health care
has been revoked or suspended (as described in
section 1128(b)(5) of the Social Security Act);
(C) that has been excluded or suspended
from a health program under section 1128 of
the Social Security Act or from any other
Federal or State health care program;
(D) with respect to whom a civil money
penalty has been imposed under this Act or the
Social Security Act; or
(E) that otherwise is subject to exclusion
from participation under a health program .
(3) HEALTH PROGRAM DEFINED.—In this sec-
tion, the term ‘‘health program’’ means a State
health security program and includes the medicare
program (under title XVIII of the Social Security
Act) and a State health care program (as defined in
section 1128(h) of such Act).
(c) REPORTING REQUIREMENT.—
(1) REPORTING.—Each State health security
program shall provide such information to the In-
spector General as the Inspector General may re-
quire in order to carry out fraud and abuse control
•HR 1200 SC4
activities and for purposes of maintaining the data
base.
(2) QUERYING.—In accordance with rules es-
tablished by the Board (in consultation with the In-
spector General), each State health security program
shall query periodically (as specified by the Inspector
General)—
(A) the data base to determine if providers
of health services for which the program makes
payment are not disqualified from providing
such services, and
(B) the Secretary of Health and Human
Services, concerning information obtained by
the Secretary under part B of the Health Care
Quality Improvement Act of 1986 relating to
practitioners.
(3) COORDINATION WITH MALPRACTICE DATA
BASE.—The Secretary of Health and Human Serv-
ices shall provide for the coordination of the report-
ing and disclosure of information under this section
with information under part B of the Health Care
Quality Improvement Act of 1986.
(4) UNIFORM MANNER.—Information shall be
reported under this subsection in a uniform manner
(in accordance with standards of the Inspector Gen-
•HR 1200 SC4
eral) that permits aggregation of reported informa-
tion.
(5) ACCESS FOR AUDIT.—Each State health se-
curity program shall provide the Inspector General
such access to information as may be required to
verify the information reported under this sub-
section.
(6) PENALTY FOR FALSE INFORMATION.—Any
person that submits false information required to be
provided under this subsection or that denies access
to information under paragraph (5) may be impris-
oned for not more than 5 years, or fined, or both,
in accordance with title 18, United States Code.
(7) CONFIDENTIALITY.—The Board shall estab-
lish rules that protect the confidentiality of the
information in the data base.
SEC. 413. REQUIREMENTS FOR OPERATION OF STATE
HEALTH CARE FRAUD AND ABUSE CONTROL
UNITS.
(a) REQUIREMENT.—In order to meet the require-
ment of section 405(b)(1)(K), each State health security
program must establish and maintain a health care fraud
and abuse control unit (in this section referred to as a
‘‘fraud unit’’) that meets requirements of this section and
other requirements of the Board. Such a unit may be a
•HR 1200 SC4
State medicaid fraud control unit (described in section
1903(q) of the Social Security Act).
(b) STRUCTURE OF UNIT.—The fraud unit must—
(1) be a single identifiable entity of the State
government;
(2) be separate and distinct from the State
agency with principal responsibility for the adminis-
tration of the State health security program; and
(3) meet 1 of the following requirements:.
(A) It must be a unit of the office of the
State Attorney General or of another depart-
ment of State government which possesses
statewide authority to prosecute individuals for
criminal violations.
(B) If it is in a State the constitution of
which does not provide for the criminal prosecu-
tion of individuals by a statewide authority and
has formal procedures, approved by the Board,
that (i) assure its referral of suspected criminal
violations relating to the State health insurance
plan to the appropriate authority or authorities
in the States for prosecution, and (ii) assure its
assistance of, and coordination with, such au-
thority or authorities in such prosecutions.