I
105TH CONGRESS
1ST SESSION
H. R. 2417
To amend the Social Security Act to fight fraud by hospitals under the
Medicare Program, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
SEPTEMBER 5, 1997
Mr. KENNEDY of Rhode Island introduced the following bill; which was
referred to the Committee on Ways and Means
A BILL
To amend the Social Security Act to fight fraud by hospitals
under the Medicare Program, 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 ‘‘Fight Hospital Fraud
in Medicare Act of 1997’’.
SEC. 2. RANDOM INVESTIGATIONS.
The Secretary of Health and Human Services shall
devise plans, in consultation with Federal, State, and local
law enforcement officials, for random investigations of
hospitals for potential violations of law under the Medicare
Program.
SEC. 3. EDUCATIONAL PROGRAM TO PROMOTE COMPLI-
ANCE.
(a) ESTABLISHMENT OF PROGRAM.—The Adminis-
trator of the Health Care Financing Administration shall
establish a program to educate hospitals on compliance
with regulations applicable under the Medicare Program.
(b) EMPHASIZE.—The education program shall em-
phasize methods of reducing noncompliance and unneces-
sary litigation and simplifying paperwork.
(c) ADMINISTRATION THROUGH LOCAL OFFICES.—
The program shall be administered, to the extent prac-
ticable, through regional offices of the Administrator.
SEC. 4. GAO REPORT ON ABUSES BY FOR-PROFIT HOS-
PITALS.
(a) STUDY.—The Comptroller General of the United
States shall conduct a study on the extent to which fines,
settlements, and overpayments under the Medicare Pro-
gram are associated with for-profit hospitals.
(b) REPORT.—Not later than 1 year after the date
of the enactment of this Act, the Comptroller General shall
submit to Congress a report on the study conducted under
subsection (a).
SEC. 5. FEES FOR HOSPITALS AGREEMENTS.
(a) IN GENERAL.—Section 1866 of the Social Secu-
rity Act (42 U.S.C. 1395cc) is amended by adding at the
end the following new subsection:
‘‘(j)(1) The Secretary is authorized to impose fees for
initiation and renewal of provider agreements with hos-
pitals, in amounts up to the full amount which the Sec-
retary reasonably estimates to be sufficient to cover the
Secretary’s costs related to the process for initiating and
reviewing such agreements. Fees collected pursuant to this
paragraph shall be credited to a special fund of the United
States Treasury, and shall remain available until ex-
pended, to the extent and in such amounts as provided
in advance in appropriations acts, for necessary expenses
for these purposes, including costs of establishing and
maintaining procedures and records systems; processing
applications; and background investigations.
‘‘(2) The Secretary shall impose the fees described
in paragraph (1) with respect to for-profit hospitals.’’.
(b) EFFECTIVE DATE.—The amendments made by
subsection (a) shall take effect on date of enactment of
this Act and section 1866(j)(2) shall apply to agreements
as of January 1, 1998.
SEC. 6. FEES AND REQUIREMENTS FOR ISSUANCE OF
STANDARD HEALTH CARE IDENTIFIERS.
Section 1173(b) of the Social Security Act (42 U.S.C.
1320d–2(b)) is amended by adding after paragraph (2)
the following new paragraph:
‘‘(3) FEES.—
‘‘(A) IN
GENERAL.—The Secretary may
impose fees for issuing such identifiers with re-
spect to health care providers that are hos-
pitals, in amounts which the Secretary reason-
ably estimates to be sufficient to cover all costs
to the Secretary associated with such activity.
‘‘(B) REQUIREMENT FOR FOR-PROFIT HOS-
PITALS.—The Secretary shall impose fees under
subparagraph (A) with respect to any entity
that is a for-profit hospital.
‘‘(C) APPLICATION
OF
AMOUNTS.—Fees
collected pursuant to this paragraph shall be
credited to a special fund of the United States
Treasury, and shall remain available until ex-
pended, to the extent and in such amounts as
provided in advance in appropriations acts, for
costs incurred by the Secretary in issuing such
identifiers, including costs of establishing and
maintaining an automated database and proce-
dures; processing applications; and verifying in-
formation provided.’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) shall take effect on the date of the enact-
ment of this Act and section 1173(b)(3)(B) of the Social
Security Act, as added by such amendment, shall apply
to the issuance of identifiers on and after January 1,
1998.
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