261 
Reform methodology under section 1704(b)(2) of the 
Empowering Patients First Act’’. 
(d) DISPROPORTIONATE SHARE HOSPITALS (DSH) 
AND ESSENTIAL ACCESS HOSPITAL (EAH) NON-DIS-
CRIMINATION.— 
(1) IN GENERAL.—Section 1923(d) of the So-
cial Security Act (42 U.S.C. 1396r–4) is amended 
by adding at the end the following new paragraph: 
‘‘(4) No hospital may be defined or deemed as 
a disproportionate share hospital, or as an essential 
access 
hospital 
(for 
purposes 
of 
subsection 
(f)(6)(A)(iv)), under a State plan under this title or 
subsection (b) of this section (including any waiver 
under section 1115) unless the hospital— 
‘‘(A) provides services to beneficiaries 
under this title without discrimination on the 
ground of race, color, national origin, creed, 
source of payment, status as a beneficiary 
under this title, or any other ground unrelated 
to such beneficiary’s need for the services or the 
availability of the needed services in the hos-
pital; and 
‘‘(B) makes arrangements for, and accepts, 
reimbursement under this title for services pro-
vided to eligible beneficiaries under this title.’’. 
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262 
(2) EFFECTIVE DATE.—The amendment made 
by subsection (a) shall be apply to expenditures 
made on or after July 1, 2011. 
Subtitle D—Fraud, Waste, and 
Abuse 
SEC. 1231. PROVIDE ADEQUATE FUNDING TO HHS OIG AND 
HCFAC. 
(a) HCFAC FUNDING.—Section 1817(k)(3)(A) of 
the Social Security Act (42 U.S.C. 1395i(k)(3)(A)) is 
amended— 
(1) in clause (i)— 
(A) in subclause (IV), by striking ‘‘2009, 
and 2010’’ and inserting ‘‘and 2009’’; and 
(B) by amending subclause (V) to read as 
follows: 
‘‘(V) for each fiscal year after fis-
cal year 2010, $300,000,000.’’; and 
(2) in clause (ii)— 
(A) in subclause (IX), by striking ‘‘2009, 
and 2010’’ and inserting ‘‘and 2009’’; and 
(B) in subclause (X), by striking ‘‘2010’’ 
and inserting ‘‘2009’’ and by inserting before 
the period at the end the following: ‘‘, plus the 
amount by which the amount made available 
under clause (i)(V) for fiscal year 2010 exceeds 
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263 
the amount made available under clause (i)(IV) 
for 2009’’. 
(b) OIG FUNDING.—There are authorized to be ap-
propriated for each of fiscal years 2011 through 2020 
$100,000,000 for the Office of the Inspector General of 
the Department of Health and Human Services for fraud 
prevention activities under the Medicare and Medicaid 
programs. 
SEC. 1232. IMPROVED ENFORCEMENT OF THE MEDICARE 
SECONDARY PAYOR PROVISIONS. 
(a) IN GENERAL.—The Secretary, in coordination 
with the Inspector General of the Department of Health 
and Human Services, shall provide through the Coordina-
tion of Benefits Contractor for the identification of in-
stances where the Medicare program should be, but is not, 
acting as a secondary payer to an individual’s private 
health benefits coverage under section 1862(b) of the So-
cial Security Act (42 U.S.C. 1395y(b)). 
(b) UPDATING PROCEDURES.—The Secretary shall 
update procedures for identifying and resolving credit bal-
ance situations which occur under the Medicare program 
when payment under such title and from other health ben-
efit plans exceed the providers’ charges or the allowed 
amount. 
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264 
(c) REPORT
ON IMPROVED ENFORCEMENT.—Not 
later than 1 year after the date of the enactment of this 
Act, the Secretary shall submit a report to Congress on 
progress made in improved enforcement of the Medicare 
secondary payor provisions, including recoupment of credit 
balances. 
SEC. 1233. STRENGTHEN MEDICARE PROVIDER ENROLL-
MENT STANDARDS AND SAFEGUARDS. 
(a) STRENGTHENING MEDICARE PROVIDER NUM-
BERS.— 
(1) SCREENING NEW PROVIDERS.—As a condi-
tion of a provider of services or a supplier, including 
durable medical equipment suppliers and home 
health agencies, applying for the first time for a pro-
vider number under the Medicare program and be-
fore granting billing privileges under such title, the 
Secretary shall screen the provider or supplier for a 
criminal background or other financial or oper-
ational irregularities through fingerprinting, licen-
sure checks, site-visits, other database checks. 
(2) APPLICATION FEES.—The Secretary shall 
impose an application charge on such a provider or 
supplier in order to cover the Secretary’s costs in 
performing the screening required under paragraph 
(1). 
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(3) PROVISIONAL APPROVAL.—During an ini-
tial, provisional period (specified by the Secretary) 
In which such a provider or supplier has been issued 
such a number, the Secretary shall provide enhanced 
oversight of the activities of such provider or sup-
plier under the Medicare program, such as through 
prepayment review and payment limitations. 
(4) PENALTIES FOR FALSE STATEMENTS.—In 
the case of a provider or supplier that knowingly 
makes a false statement in an application for such 
a number, the Secretary may exclude the provider or 
supplier from participation under the Medicare pro-
gram, or may impose a civil money penalty (in the 
amount described in section 1128A(a)(4) of the So-
cial Security Act), in the same manner as the Sec-
retary may impose such an exclusion or penalty 
under sections 1128 and 1128A, respectively, of 
such Act in the case of knowing presentation of a 
false claim described in section 1128A(a)(1)(A) of 
such Act. 
(5) DISCLOSURE
REQUIREMENTS.—With re-
spect to approval of such an application, the Sec-
retary— 
(A) shall require applicants to disclose pre-
vious affiliation with enrolled entities that have 
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