I 
112TH CONGRESS 
1ST SESSION 
H. R. 675 
To amend title XI of the Social Security Act to expand the permissive 
exclusion from participation in Federal health care programs to individ-
uals and entities affiliated with sanctioned entities. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 11, 2011 
Mr. HERGER (for himself, Mr. STARK, Mr. NUNES, Mr. LEVIN, Mr. TIBERI, 
Mr. RANGEL, Mr. DAVIS of Kentucky, Mr. MCDERMOTT, Mr. REICHERT, 
Mr. LEWIS of Georgia, Mr. BOUSTANY, Mr. NEAL, Mr. HELLER, Mr. 
DOGGETT, Mr. GERLACH, Mr. LARSON of Connecticut, Mr. BUCHANAN, 
Mr. BLUMENAUER, Mr. PAULSEN, Mr. KIND, and Mr. PASCRELL) intro-
duced 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 Budget, 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 title XI of the Social Security Act to expand 
the permissive exclusion from participation in Federal 
health care programs to individuals and entities affiliated 
with sanctioned entities. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Strengthening Medi-
care Anti-Fraud Measures Act of 2011’’. 
SEC. 2. PERMISSIVE EXCLUSION FROM FEDERAL HEALTH 
CARE PROGRAMS EXPANDED TO INDIVID-
UALS AND ENTITIES AFFILIATED WITH SANC-
TIONED ENTITIES. 
Section 1128(b)(15) of the Social Security Act (42 
U.S.C. 1320a–7(b)(15)) is amended to read as follows: 
‘‘(15) INDIVIDUALS OR ENTITIES AFFILIATED 
WITH A SANCTIONED ENTITY.—(A) Any of the fol-
lowing: 
‘‘(i) Any individual who— 
‘‘(I) is a person with an ownership or 
control interest (as defined in section 
1124(a)(3)) in a sanctioned entity or an 
affiliated entity of such sanctioned entity 
(or was a person with such an interest at 
the time of any of the conduct that formed 
a basis for the conviction or exclusion de-
scribed in subparagraph (B)); and 
‘‘(II) knows or should know (as de-
fined in section 1128A(i)(7)) (or knew or 
should have known) of such conduct. 
‘‘(ii) Any individual who is an officer or 
managing employee (as defined in section 
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1126(b)) of a sanctioned entity or affiliated en-
tity of such sanctioned entity (or was such an 
officer or managing employee at the time of any 
of the conduct that formed a basis for the con-
viction or exclusion described in subparagraph 
(B)). 
‘‘(iii) Any affiliated entity of a sanctioned 
entity. 
‘‘(B) For purposes of this paragraph, the term 
‘sanctioned entity’ means an entity— 
‘‘(i) that has been convicted of any offense 
described in subsection (a) or in paragraph (1), 
(2), or (3) of this subsection; or 
‘‘(ii) that has been excluded from partici-
pation under a program under title XVIII or 
under a State health care program. 
‘‘(C)(i) For purposes of this paragraph, the 
term ‘affiliated entity’ means, with respect to a 
sanctioned entity— 
‘‘(I) an entity affiliated with such sanc-
tioned entity; and 
‘‘(II) an entity that was so affiliated at the 
time of any of the conduct that formed the 
basis for the conviction or exclusion described 
in subparagraph (B). 
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‘‘(ii) For purposes of clause (i), an entity 
shall be treated as affiliated with another entity 
if— 
‘‘(I) one of the entities is a person 
with an ownership or control interest (as 
defined in section 1124(a)(3)) in the other 
entity (or had such an interest at the time 
of any of the conduct that formed a basis 
for the conviction or exclusion described in 
subparagraph (B)); 
‘‘(II) there is a person with an owner-
ship or control interest (as defined in sec-
tion 1124(a)(3)) in both entities (or had 
such an interest at the time of any of the 
conduct that formed a basis for the convic-
tion or exclusion described in subpara-
graph (B)); or 
‘‘(III) there is a person who is an offi-
cer or managing employee (as defined in 
section 1126(b)) of both entities (or was 
such an officer or managing employee at 
the time of any of the conduct that formed 
a basis for the conviction or exclusion de-
scribed in subparagraph (B)).’’. 
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SEC. 3. BUDGETARY EFFECTS OF PAYGO LEGISLATION. 
The budgetary effects of this Act, for the purpose of 
complying with the Statutory Pay-As-You-Go Act of 2010, 
shall be determined by reference to the latest statement 
titled ‘‘Budgetary Effects of PAYGO Legislation’’ for this 
Act, submitted for printing in the Congressional Record 
by the Chairman of the House Budget Committee, pro-
vided that such statement has been submitted prior to the 
vote on passage. 
Æ 
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