I 
114TH CONGRESS 
1ST SESSION H. R. 1083 
To amend titles XVIII and XIX of the Social Security Act to apply the 
Medicare restriction on self-referral to State plan requirements under 
Medicaid, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 25, 2015 
Mr. MCDERMOTT introduced the following bill; which was referred to the 
Committee on Energy 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 jurisdiction of the committee concerned 
A BILL 
To amend titles XVIII and XIX of the Social Security Act 
to apply the Medicare restriction on self-referral to State 
plan requirements under Medicaid, and for other pur-
poses. 
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 ‘‘Medicaid Physician 
Self-Referral Act of 2015’’. 
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SEC. 2. ADJUSTMENTS TO RESTRICTION ON SELF-REFER-
RAL UNDER MEDICAID. 
(a) REPEAL OF RESTRICTION ON RECEIPT OF FED-
ERAL FUNDS IN THE CASE OF SELF-REFERRAL.—Sub-
section (s) of section 1903 of the Social Security Act (42 
U.S.C. 1396b) is repealed. 
(b) REQUIREMENT OF RESTRICTION ON SELF-RE-
FERRAL IN STATE PLAN REQUIREMENTS.—Section 1902 
of such Act (42 U.S.C. 1396a) is amended— 
(1) in subsection (a)— 
(A) in paragraph (80) by striking ‘‘and’’ at 
the end; 
(B) in paragraph (81) by striking the pe-
riod at the end and inserting ‘‘; and’’; 
(C) by inserting after paragraph (81) the 
following: 
‘‘(82) provide that no payment may be made 
under the State plan for a Medicaid designated 
health service furnished to an individual on the basis 
of a referral by a physician if the physician (or an 
immediate family member of the physician) has an 
ownership or investment interest or a compensation 
arrangement (as defined in section 1877) with the 
entity furnishing the Medicaid designated health 
service that would not comply with section 1877 if 
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the referral were for an item or service otherwise 
payable under title XVIII.’’; and 
(D) by inserting after the matter imme-
diately following paragraph (82) the following: 
‘‘For purposes of paragraph (82), subsections (f) and (g) 
of section 1877 shall apply to a provider of a Medicaid 
designated health service in a similar manner as such sub-
sections apply to a provider of an item or service for which 
payment may be made under title XVIII.’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(ll) 
DEFINITION
OF
MEDICAID
DESIGNATED 
HEALTH SERVICE.—For purposes of subsection (a) the 
term ‘Medicaid designated health service’ means an item 
or service listed in subsection (h)(6) of section 1877 as 
covered by a State plan and any other service a State may 
choose to add for purposes of subsection (a)(82).’’. 
(c) APPLICATION OF FALSE CLAIMS ACT TO VIOLA-
TIONS OF SELF-REFERRAL.—Section 1877(g) of such Act 
(42 U.S.C. 1395nn(g)) is amended by adding at the end 
the following: 
‘‘(7) FALSE
CLAIMS
ACT.—A claim that in-
cludes an item or service resulting from a violation 
of this section constitutes a false or fraudulent claim 
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