I 
115TH CONGRESS 
1ST SESSION H. R. 3726 
To amend title XVIII of the Social Security Act to create alternative sanctions 
for technical noncompliance with the Stark rule under Medicare, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 11, 2017 
Mr. MARCHANT (for himself, Mr. KIND, and Mr. MEEHAN) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To amend title XVIII of the Social Security Act to create 
alternative sanctions for technical noncompliance with 
the Stark rule under Medicare, and for other purposes. 
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 ‘‘Stark Administrative 
Simplification Act of 2017’’. 
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SEC. 2. ALTERNATIVE SANCTIONS FOR TECHNICAL NON-
COMPLIANCE 
WITH 
STARK 
RULE 
UNDER 
MEDICARE. 
Section 1877 of the Social Security Act (42 U.S.C. 
1395nn) is amended by adding at the end the following 
new subsection: 
‘‘(j) SELF-DISCLOSURE PROTOCOLS.— 
‘‘(1) IN GENERAL.—Beginning one year after 
the date of the enactment of this subsection— 
‘‘(A) an entity or individual may volun-
tarily disclose a compensation arrangement with 
actual or potential inadvertent technical non-
compliance with subsection (a)(1) (as defined in 
paragraph (3)(G)) pursuant to either the self- 
referral disclosure protocol (defined in para-
graph (2)) or the alternative protocol for tech-
nical noncompliance under paragraph (3); 
‘‘(B) disclosures voluntarily withdrawn 
from the alternative protocol for technical non-
compliance may be submitted to the self-refer-
ral disclosure protocol; and 
‘‘(C) an entity that, prior to the establish-
ment of the alternative protocol for technical 
noncompliance, disclosed to the self-referral dis-
closure protocol a compensation arrangement 
that was in inadvertent technical noncompliance 
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with subsection (a)(1), may elect, not later than 
one year after such alternative protocol is estab-
lished, to withdraw such disclosure from the 
self-referral disclosure protocol and instead sub-
mit the disclosure to such alternative protocol. 
‘‘(2) 
SELF-REFERRAL
DISCLOSURE
PRO-
TOCOL.—The term ‘self-referral disclosure protocol’ 
or ‘SRDP’ means the protocol specified in section 
6409 of Public Law 111–148. 
‘‘(3) ALTERNATIVE
PROTOCOL
FOR
INAD-
VERTENT TECHNICAL NONCOMPLIANCE.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
establish, not later than one year after the date 
of the enactment of this subsection, an alter-
native protocol for technical noncompliance (in 
this subsection referred to as the ‘APTN’) to 
enable entities to disclose arrangements that 
were previously in inadvertent technical non-
compliance with subsection (a)(1) and, upon the 
Secretary’s acceptance of the disclosure, make 
payment of a civil monetary penalty. Payment 
of such civil monetary penalty for an arrange-
ment shall resolve only overpayments due and 
owing as a result of such arrangement’s inad-
vertent technical noncompliance with this sec-
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tion. The provisions of section 6409 of Public 
Law 111–148 shall not apply to this subsection. 
‘‘(B) DISCLOSURE
REQUIREMENTS.—Ar-
rangements disclosed to the APTN must— 
‘‘(i) involve only inadvertent technical 
noncompliance with subsection (a)(1) that 
was ended by termination or expiration of 
the arrangement, or by action of the par-
ties to the arrangement to resolve the tech-
nical noncompliance, prior to the date of 
submission of the disclosure to the APTN; 
‘‘(ii) be made in the form and manner 
specified by the Secretary on the public 
Internet website of the Centers for Medi-
care & Medicaid Services and include de-
scriptions of— 
‘‘(I) the compensation arrange-
ment that was in technical noncompli-
ance with subsection (a)(1); 
‘‘(II) how and when the technical 
noncompliance with subsection (a)(1) 
was ended or the arrangement was 
otherwise terminated; and 
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‘‘(III) how the remuneration paid 
under the compensation arrangement 
being disclosed was— 
‘‘(aa) consistent with the 
fair market value of the items 
and services that were provided 
under the compensation arrange-
ment; and 
‘‘(bb) not determined in a 
manner that directly or indirectly 
takes into account the volume or 
value of referrals or other busi-
ness generated between the par-
ties; 
‘‘(iii) include a form settlement agree-
ment provided by the Secretary signed by 
the entity; and 
‘‘(iv) include a certification from the 
entity that, to the best of the entity’s 
knowledge, the information provided is 
truthful information and is based on a 
good faith effort to bring the matter to the 
Secretary’s attention. 
‘‘(C) ACCEPTANCE OR REJECTION OF DIS-
CLOSURE BY THE SECRETARY.—The following 
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rules shall apply to the acceptance or rejection 
of a disclosure under the APTN: 
‘‘(i) The Secretary shall accept or re-
ject a complete, accurate, and timely dis-
closure. 
‘‘(ii) Upon receipt of a disclosure, the 
Secretary shall notify the disclosing party 
of such receipt. 
‘‘(iii) The Secretary may request addi-
tional information from the disclosing 
party. 
‘‘(iv) Upon acceptance by the Sec-
retary, the Secretary shall notify the dis-
closing party in writing of such acceptance. 
‘‘(v) The disclosure shall be rejected 
if— 
‘‘(I) the disclosing party fails to 
furnish the additional information re-
quested by the Secretary in such form 
and manner as the Secretary may 
specify; or 
‘‘(II) in the Secretary’s sole de-
termination, the noncompliance dis-
closed did not meet the disclosure re-
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quirements specified in subparagraph 
(B). 
‘‘(vi) The disclosure shall be accepted 
if the Secretary— 
‘‘(I) has issued a written notice 
to the disclosing party that the disclo-
sure is determined to satisfy the re-
quirements for disclosures under this 
section; or 
‘‘(II) has not rejected a complete, 
accurate, and timely disclosure that 
satisfies each of the requirements for 
disclosures under this section and 180 
calendar days have passed since noti-
fication of receipt by the Secretary of 
the disclosure. 
‘‘(vii) In determining whether to ac-
cept a disclosure, the Secretary may rea-
sonably rely on the information and certifi-
cations included in the disclosure. 
‘‘(D) WITHDRAWAL
OF
DISCLOSURE.— 
Prior to acceptance or rejection of a disclosure 
by the Secretary, an entity may voluntarily 
withdraw such disclosure from the APTN. 
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‘‘(E) CIVIL MONETARY PENALTIES PURSU-
ANT
TO
THE
ALTERNATIVE
PROTOCOL
FOR 
TECHNICAL NONCOMPLIANCE.— 
‘‘(i) IN GENERAL.—Subject to clause 
(ii), for each arrangement disclosed under 
this subsection and accepted under sub-
paragraph (C), the Secretary shall impose 
a single civil monetary penalty of— 
‘‘(I) $5,000, in the case in which 
disclosure of the inadvertent tech-
nically noncompliant compensation ar-
rangement was submitted to the Sec-
retary not later than the date that is 
one year after the initial date of inad-
vertent technical noncompliance with 
subsection (a)(1); or 
‘‘(II) $10,000, in the case in 
which the disclosure of the technically 
noncompliant compensation arrange-
ment was submitted to the Sec-
retary— 
‘‘(aa) after the date that is 
more than one year after the ini-
tial date of the entity’s inad-
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vertent technical noncompliance 
with subsection (a)(1); and 
‘‘(bb) not after the date that 
is 3 years (or, in the case of a 
disclosure submitted after the 
5th year for which this sub-
section applies, the date that is 2 
years) from the initial date of the 
entity’s 
inadvertent 
technical 
noncompliance with subsection 
(a)(1). 
‘‘(ii) SPECIAL
RULE
FOR
ENTITIES 
THAT
DISCLOSED
TO
THE
APTN
AFTER 
WITHDRAWING A DISCLOSURE FROM THE 
SRDP.—In the case of an entity that elects 
under paragraph (1)(C) to withdraw a dis-
closure from the self-referral disclosure 
protocol and instead submit the disclosure 
to the APTN under this subsection, in de-
termining the applicable civil monetary 
penalty under clause (i), the date of disclo-
sure to the self-referral disclosure protocol 
(as defined in paragraph (2)) shall be sub-
stituted for the date of disclosure to the 
APTN. 
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‘‘(F) RELATION TO ADVISORY OPINIONS.— 
The APTN shall be separate from the advisory 
opinion process set forth in regulations imple-
menting subsection (g) of this section. 
‘‘(G) PUBLICATION ON INTERNET WEBSITE 
OF APTN INFORMATION.—Not later than one 
year after the date of the enactment of this sec-
tion, the Secretary shall post information on the 
public Internet website of the Centers for Medi-
care & Medicaid Services to inform relevant 
stakeholders of how to disclose and make pay-
ment of a civil monetary penalty for inadvertent 
technical noncompliance with subsection (a)(1). 
‘‘(H) DEFINITIONS.—In this subsection: 
‘‘(i) TECHNICAL
NONCOMPLIANCE.— 
The term ‘technical noncompliance with 
subsection (a)(1)’ means, with respect to a 
compensation arrangement, that— 
‘‘(I) the arrangement is not 
signed by one or more parties to the 
arrangement; 
‘‘(II) following the expiration of 
the arrangement, the arrangement 
was a holdover arrangement for a pe-
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riod longer than permitted in regula-
tions issued by the Secretary; or 
‘‘(III) the contemporaneous writ-
ten documentation evidencing the 
terms of the arrangement identifies 
the parties to the arrangement and 
the items, services, space, or equip-
ment, as applicable, but is not suffi-
cient to satisfy the writing require-
ment of an applicable exception. 
‘‘(ii) INADVERTENT.—The term ‘inad-
vertent’ means, with respect to a com-
pensation arrangement that is in non-
compliance, that an entity that is a party 
to the compensation arrangement did not 
know or should not have known of the non-
compliance. 
‘‘(I) ADMINISTRATION.—Chapter 35 of 
title 44, United States Code, shall not apply to 
this subsection. 
‘‘(J) IMPLEMENTATION.—Notwithstanding 
any other provision of law, the Secretary may 
implement the provisions of this paragraph by 
program instruction or otherwise.’’. 
Æ 
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