I 
112TH CONGRESS 
1ST SESSION H. R. 3399 
To amend titles XVIII and XIX of the Social Security Act to curb waste, 
fraud, and abuse in the Medicare and Medicaid programs. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 10, 2011 
Mr. ROSKAM (for himself and Mr. CARNEY) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committees on Ways and Means and the Judiciary, 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 com-
mittee concerned 
A BILL 
To amend titles XVIII and XIX of the Social Security Act 
to curb waste, fraud, and abuse in the Medicare and 
Medicaid programs. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Medicare and Medicaid Fighting Fraud and Abuse to 
Save Taxpayers’ Dollars Act’’ or the ‘‘Medicare and Med-
icaid FAST Act’’. 
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(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—PREVENTING PRESCRIPTION DRUG WASTE, FRAUD, 
AND ABUSE 
Sec. 101. Requiring valid National Provider Identifiers of prescribers on phar-
macy claims and limiting access to the National Provider Iden-
tifier Registry. 
Sec. 102. Encouraging the establishment of State prescription drug monitoring 
programs. 
Sec. 103. Updating of DEA database of controlled substances providers. 
TITLE II—CURBING IMPROPER PAYMENTS 
Sec. 201. Addressing vulnerabilities identified by Recovery Audit Contractors. 
Sec. 202. Improving Senior Medicare Patrol and fraud reporting rewards. 
Sec. 203. Prohibiting the display of Social Security account numbers on newly 
issued Medicare identification cards and communications pro-
vided to Medicare beneficiaries. 
Sec. 204. Requiring prior authorization of initial claims for standard power 
wheelchairs. 
Sec. 205. Strengthening Medicaid program integrity through flexibility. 
TITLE III—IMPROVING DATA SHARING ACROSS AGENCIES AND 
PROGRAMS 
Sec. 301. Improving data sharing across agencies and programs. 
Sec. 302. Expanding automated prepayment review of Medicare claims. 
Sec. 303. Improving the sharing of data between the Federal Government and 
State Medicaid programs. 
Sec. 304. Improving claims processing and detection of fraud within the Med-
icaid and CHIP programs. 
Sec. 305. Reports. 
TITLE IV—IMPROVING CMS CONTRACTOR PERFORMANCE 
Sec. 401. Establishing Medicare administrative contractor error reduction in-
centives. 
Sec. 402. Separating provider enrollment and screening from Medicare adminis-
trative contractors. 
Sec. 403. Developing measurable performance metrics for Medicare contractors. 
TITLE V—OTHER PROVISIONS 
Sec. 501. Strengthening penalties for the illegal distribution of a Medicare, 
Medicaid, or CHIP beneficiary identification or billing privi-
leges. 
Sec. 502. Providing implementation funding. 
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TITLE 
I—PREVENTING 
PRE-
SCRIPTION 
DRUG 
WASTE, 
FRAUD, AND ABUSE 
SEC. 101. REQUIRING VALID NATIONAL PROVIDER IDENTI-
FIERS 
OF 
PRESCRIBERS 
ON 
PHARMACY 
CLAIMS AND LIMITING ACCESS TO THE NA-
TIONAL PROVIDER IDENTIFIER REGISTRY. 
(a) REQUIRING VALID NATIONAL PROVIDER IDENTI-
FIERS OF PRESCRIBERS ON PHARMACY CLAIMS.—Section 
1860D–4(c) of the Social Security Act (42 U.S.C. 1395w– 
104(c)) is amended by adding at the end the following new 
paragraph: 
‘‘(4) REQUIRING
VALID
NATIONAL
PROVIDER 
IDENTIFIERS
OF
PRESCRIBERS
ON
PHARMACY 
CLAIMS.— 
‘‘(A) IN GENERAL.—For plan year 2013 
and subsequent plan years, subject to subpara-
graph (B), the Secretary shall prohibit PDP 
sponsors of prescription drug plans from paying 
claims for prescription drugs under this part 
that do not include the valid National Provider 
Identifier for the drug’s prescriber. 
‘‘(B) PROCEDURES.—The Secretary shall 
establish— 
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