149 
(1) and that is revenue neutral to the Federal Gov-
ernment. 
(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 makes a false 
statement in an application for such a number, the 
Secretary may exclude the provider or supplier from 
participation under the Medicare program, or may 
impose a civil money penalty (in the amount de-
scribed in section 1128A(a)(4) of the Social Security 
Act), in the same manner as the Secretary may im-
pose such an exclusion or penalty under sections 
1128 and 1128A, respectively, of such Act in the 
case of knowing presentation of a false claim de-
scribed in section 1128A(a)(1)(A) of such Act. 
(5) DISCLOSURE
REQUIREMENTS.—With re-
spect to approval of such an application, the Sec-
retary— 
VerDate Mar 15 2010 
04:27 Jan 21, 2011
Jkt 099200
PO 00000
Frm 00149
Fmt 6652
Sfmt 6201
E:\BILLS\H364.IH
H364
smartinez on DSKB9S0YB1PROD with BILLS
150 
(A) shall require applicants to disclose pre-
vious affiliation with enrolled entities that have 
uncollected debt related to the Medicare or 
Medicaid programs; 
(B) may deny approval if the Secretary de-
termines that these affiliations pose undue risk 
to the Medicare or Medicaid program, subject 
to an appeals process for the applicant as deter-
mined by the Secretary; and 
(C) may implement enhanced safeguards 
(such as surety bonds). 
(b) MORATORIA.—The Secretary of Health and 
Human Services may impose moratoria on approval of 
provider and supplier numbers under the Medicare pro-
gram for new providers of services and suppliers as deter-
mined necessary to prevent or combat fraud a period of 
delay for any one applicant cannot exceed 30 days unless 
cause is shown by the Secretary. 
(c) FUNDING.— 
(1) IN GENERAL.—There are authorized to be 
appropriated to carry out this section such sums as 
may be necessary. 
(2) CONDITION.—The provisions of paragraphs 
(1) and (2) of subsection (a) shall not apply unless 
VerDate Mar 15 2010 
04:27 Jan 21, 2011
Jkt 099200
PO 00000
Frm 00150
Fmt 6652
Sfmt 6201
E:\BILLS\H364.IH
H364
smartinez on DSKB9S0YB1PROD with BILLS
151 
and until funds are appropriated to carry out such 
provisions. 
SEC. 604. TRACKING BANNED PROVIDERS ACROSS STATE 
LINES. 
(a) GREATER COORDINATION.—The Secretary of 
Health and Human Services shall provide for increased 
coordination between the Administrator of the Centers for 
Medicare & Medicaid Services (in this section referred to 
as ‘‘CMS’’) and its regional offices to ensure that pro-
viders of services and suppliers that have operated in one 
State and are excluded from participation in the Medicare 
program are unable to begin operation and participation 
in the Medicare program in another State. 
(b) IMPROVED INFORMATION SYSTEMS.— 
(1) IN GENERAL.—The Secretary shall improve 
information systems to allow greater integration be-
tween databases under the Medicare program so 
that— 
(A) Medicare administrative contractors, 
fiscal intermediaries, and carriers have imme-
diate access to information identifying providers 
and suppliers excluded from participation in the 
Medicare and Medicaid program and other Fed-
eral health care programs; and 
VerDate Mar 15 2010 
04:27 Jan 21, 2011
Jkt 099200
PO 00000
Frm 00151
Fmt 6652
Sfmt 6201
E:\BILLS\H364.IH
H364
smartinez on DSKB9S0YB1PROD with BILLS
152 
(B) such information can be shared across 
Federal health care programs and agencies, in-
cluding between the Departments of Health and 
Human Services, the Social Security Adminis-
tration, the Department of Veterans Affairs, 
the Department of Defense, the Department of 
Justice, and the Office of Personnel Manage-
ment. 
(c) MEDICARE/MEDICAID ‘‘ONE PI’’ DATABASE.— 
The Secretary shall implement a database that includes 
claims and payment data for all components of the Medi-
care program and the Medicaid program. 
(d) AUTHORIZING EXPANDED DATA MATCHING.— 
Notwithstanding any provision of the Computer Matching 
and Privacy Protection Act of 1988 to the contrary— 
(1) the Secretary and the Inspector General in 
the Department of Health and Human Services may 
perform data matching of data from the Medicare 
program with data from the Medicaid program; and 
(2) the Commissioner of Social Security and the 
Secretary may perform data matching of data of the 
Social Security Administration with data from the 
Medicare and Medicaid programs. 
(e) CONSOLIDATION OF DATABASES.—The Secretary 
shall consolidate and expand into a centralized database 
VerDate Mar 15 2010 
04:27 Jan 21, 2011
Jkt 099200
PO 00000
Frm 00152
Fmt 6652
Sfmt 6201
E:\BILLS\H364.IH
H364
smartinez on DSKB9S0YB1PROD with BILLS
153 
for individuals and entities that have been excluded from 
Federal health care programs the Healthcare Integrity 
and Protection Data Bank, the National Practitioner 
Data Bank, the List of Excluded Individuals/Entities, and 
a national patient abuse/neglect registry. 
(f) COMPREHENSIVE PROVIDER DATABASE.— 
(1) ESTABLISHMENT.—The Secretary shall es-
tablish a comprehensive database that includes infor-
mation on providers of services, suppliers, and re-
lated entities participating in the Medicare program, 
the Medicaid program, or both. Such database shall 
include, information on ownership and business rela-
tionships, history of adverse actions, results of site 
visits or other monitoring by any program. 
(2) USE.—Prior to issuing a provider or sup-
plier number for an entity under the Medicare pro-
gram, the Secretary shall obtain information on the 
entity from such database to assure the entity quali-
fies for the issuance of such a number. 
(g) COMPREHENSIVE SANCTIONS DATABASE.—The 
Secretary shall establish a comprehensive sanctions data-
base on sanctions imposed on providers of services, sup-
pliers, and related entities. Such database shall be over-
seen by the Inspector General of the Department of 
Health and Human Services and shall be linked to related 
VerDate Mar 15 2010 
04:27 Jan 21, 2011
Jkt 099200
PO 00000
Frm 00153
Fmt 6652
Sfmt 6201
E:\BILLS\H364.IH
H364
smartinez on DSKB9S0YB1PROD with BILLS
154 
databases maintained by State licensure boards and by 
Federal or State law enforcement agencies. 
(h) ACCESS
TO
CLAIMS
AND
PAYMENT
DATA-
BASES.—The Secretary shall ensure that the Inspector 
General of the Department of Health and Human Services 
and Federal law enforcement agencies have direct access 
to all claims and payment databases of the Secretary 
under the Medicare or Medicaid programs. 
(i) CIVIL MONEY PENALTIES FOR SUBMISSION OF 
ERRONEOUS INFORMATION.—In the case of a provider of 
services, supplier, or other entity that submits erroneous 
information that serves as a basis for payment of any enti-
ty under the Medicare or Medicaid program, the Secretary 
may impose a civil money penalty of not to exceed $50,000 
for each such erroneous submission. A civil money penalty 
under this subsection shall be imposed and collected in the 
same manner as a civil money penalty under subsection 
(a) of section 1128A of the Social Security Act is imposed 
and collected under that section. 
Æ 
VerDate Mar 15 2010 
04:27 Jan 21, 2011
Jkt 099200
PO 00000
Frm 00154
Fmt 6652
Sfmt 6301
E:\BILLS\H364.IH
H364
smartinez on DSKB9S0YB1PROD with BILLS