100 
‘‘(1) AVAILABILITY.—The information in the 
data bank maintained under this section shall be 
available to— 
‘‘(A) Federal and State government agen-
cies and health plans, and any health care pro-
vider, supplier, or practitioner entering an em-
ployment or contractual relationship with an in-
dividual or entity who could potentially be the 
subject of a final adverse action, where the con-
tract involves the furnishing of items or services 
reimbursed by one or more Federal health care 
programs (regardless of whether the individual 
or entity is paid by the programs directly, or 
whether the items or services are reimbursed di-
rectly or indirectly through the claims of a di-
rect provider); and 
‘‘(B) utilization and quality control peer 
review organizations and accreditation entities 
as defined by the Secretary, including but not 
limited to organizations described in part B of 
this title and in section 1154(a)(4)(C).’’. 
(b) NO FEES FOR USE OF HIPDB BY ENTITIES 
CONTRACTING WITH MEDICARE.—Section 1128E(d)(2) 
of the Social Security Act (42 U.S.C. 1320a–7e(d)(2)) is 
amended by striking ‘‘Federal agencies’’ and inserting 
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101 
‘‘Federal agencies or other entities, such as fiscal inter-
mediaries and carriers, acting under contract on behalf of 
such agencies’’. 
(c) CRIMINAL PENALTY FOR MISUSE OF INFORMA-
TION.—Section 1128B(b) of the Social Security Act (42 
U.S.C. 1320a–7b(b)) is amended by adding at the end the 
following: 
‘‘(4) Whoever knowingly uses information maintained 
in the healthcare integrity and protection data bank main-
tained in accordance with section 1128E for a purpose 
other than a purpose authorized under that section shall 
be imprisoned for not more than three years or fined 
under title 18, United States Code, or both.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on the date of the enactment 
of this Act. 
SEC. 264. LIABILITY OF MEDICARE ADMINISTRATIVE CON-
TRACTORS FOR CLAIMS SUBMITTED BY EX-
CLUDED PROVIDERS. 
(a) REIMBURSEMENT
TO
THE
SECRETARY
FOR 
AMOUNTS PAID
TO EXCLUDED PROVIDERS.—Section 
1874A(b) of the Social Security Act (42 U.S.C. 
1395kk(b)) is amended by adding at the end the following 
new paragraph: 
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102 
‘‘(6) REIMBURSEMENTS
TO
SECRETARY
FOR 
AMOUNTS
PAID
TO
EXCLUDED
PROVIDERS.—The 
Secretary shall not enter into a contract with a 
Medicare administrative contractor under this sec-
tion unless the contractor agrees to reimburse the 
Secretary for any amounts paid by the contractor 
for a service under this title which is furnished by 
an individual or entity during any period for which 
the individual or entity is excluded, pursuant to sec-
tion 1128, 1128A, or 1156, from participation in the 
health care program under this title if the amounts 
are paid after the 60-day period beginning on the 
date the Secretary provides notice of the exclusion to 
the contractor, unless the payment was made as a 
result of incorrect information provided by the Sec-
retary or the individual or entity excluded from par-
ticipation has concealed or altered their identity.’’. 
(b) CONFORMING REPEAL OF MANDATORY PAYMENT 
RULE.—Section 1862(e) of the Social Security Act (42 
U.S.C. 1395y(e)) is amended— 
(1) in paragraph (1)(B), by striking ‘‘and when 
the person’’ and all that follows through ‘‘person)’’; 
and 
(2) by amending paragraph (2) to read as fol-
lows: 
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103 
‘‘(2) No individual or entity may bill (or collect any 
amount from) any individual for any item or service for 
which payment is denied under paragraph (1). No indi-
vidual is liable for payment of any amounts billed for such 
an item or service in violation of the preceding sentence.’’. 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—The amendments made by 
this section shall apply to claims for payment sub-
mitted on or after the date of the enactment of this 
Act. 
(2) CONTRACT MODIFICATION.—The Secretary 
of Health and Human Services shall take such steps 
as may be necessary to modify contracts entered 
into, renewed, or extended prior to the date of the 
enactment of this Act to conform such contracts to 
the provisions of this section. 
SEC. 265. COMMUNITY MENTAL HEALTH CENTERS. 
(a) IN GENERAL.—Section 1861(ff)(3)(B) of the So-
cial Security Act (42 U.S.C. 1395x(ff)(3)(B)) is amended 
by striking ‘‘entity that—’’ and all that follows and insert-
ing the following: ‘‘entity that— 
‘‘(i) provides the community mental health serv-
ices specified in paragraph (1) of section 1913(c) of 
the Public Health Service Act; 
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‘‘(ii) meets applicable certification or licensing 
requirements for community mental health centers 
in the State in which it is located; 
‘‘(iii) provides a significant share of its services 
to individuals who are not eligible for benefits under 
this title; and 
‘‘(iv) meets such additional standards or re-
quirements for obtaining billing privileges under this 
title as the Secretary may specify to ensure— 
‘‘(I) the health and safety of beneficiaries 
receiving such services; or 
‘‘(II) the furnishing of such services in an 
effective and efficient manner.’’. 
(b) RESTRICTION.—Section 1861(ff)(3)(A) of such 
Act (42 U.S.C. 1395x(ff)(3)(A)) is amended by inserting 
‘‘other than in an individual’s home or in an inpatient or 
residential setting’’ before the period. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after the first day of the sixth month that begins after 
the date of the enactment of this Act. 
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