Fighting Fraud and Abuse to Save Taxpayers' Dollars Act

Bill: 111-hr-6378
Sponsor: Rep. Roskam, Peter J. [R-IL-6]
Introduced: 2010-09-29 in the House
Policy area: Health
Subjects: Administrative remedies
Bankruptcy
Child health
Congressional oversight
Fraud offenses and financial crimes
Government information and archives
Government studies and investigations
Health care costs and insurance
Health information and medical records
Health personnel
Health programs administration and funding
Intergovernmental relations
Licensing and registrations
Medicaid
Medicare
Performance measurement
Poverty and welfare assistance
Public contracts and procurement
Social security and elderly assistance
User charges and fees

Summary:
action_date: 2010-09-29
text: 
Fighting Fraud and Abuse to Save Taxpayers' Dollars Act or FAST Act - Directs the Secretary of Health and Human Services (HHS), in order to ensure that service providers and suppliers that have operated in one state but are excluded from participation in the Medicare program are unable to participate in other federal health care programs in another state, to provide for increased coordination among specified federal, state, and related agencies.
 
Requires the Secretary to allow greater integration between Medicare databases so that: (1) Medicare administrative contractors, fiscal intermediaries, and carriers have immediate access to information identifying providers and suppliers excluded from participation in programs under titles XVIII (Medicare), XIX (Medicaid), or XXI (Children's Health Insurance Program) (CHIP) of the Social Security Act (SSA), as well as other federal health care programs; and (2) such information can be shared on a real-time basis across federal health care programs and agencies, and with state health agencies, state Medicaid and CHIP plans, and related contractors.
 
Requires the Secretary to implement fully the waste, fraud, and abuse detection solution of the Centers for Medicare & Medicaid Services called the One PI project by January 1, 2013.
 
Grants federal and state agencies real-time access to the National Practitioner Data Bank. Authorizes the Secretary to allow state Medicaid fraud control units and state and local law enforcement officials access to federal Medicare, Medicaid, and CHIP claims and payment data.
 
Directs the Comptroller General to study and report to Congress on whether and, if so, to what degree, the Federation of State Medical Boards may be useful in further strengthening the integrity of processes for enrolling service providers and suppliers under federal health care programs.
 
Amends the SSA, as amended by the Patient Protection and Affordable Care Act, to authorize information in the National Practitioner Data Bank to be made available on a real-time basis to specified federal, state, and private health care entities.
 
Directs the Secretary to establish an appeals process under which service providers or suppliers may have their names removed from the National Practitioner Data Bank.
 
Prohibits the Secretary from contracting with a Medicare administrative contractor unless the contractor agrees to reimburse the Secretary for any amounts paid for any non-emergency item or service furnished by or at the medical direction of an individual or entity excluded from Medicare participation.
 
Denies discharge in bankruptcy proceedings of: (1) civil monetary penalties; (2) amounts due the Secretary for overpayment of service providers where a health care provider or a supplier engages in fraudulent activity; or (3) amounts due from breach of a scholarship or loan contract.
 
Prohibits Medicaid or CHIP payments for items or services unless the claim contains a valid beneficiary identification number and a valid National Provider Identifier.
 
Requires managed care entities and Medicaid managed care organizations to comply with certain screening, oversight, and reporting requirements.
 
Subjects to specified criminal penalties the knowing, intentional, and fraudulent purchase, sale, or distribution of a Medicare, Medicaid, or CHIP beneficiary identification number or billing privileges.
 
Directs the Secretary to establish a two-year pilot program under which Medicare claims for items covered by universal product numbers (UPNs) contain the UPN.
 
Requires the Secretary to establish cost-effective procedures to ensure that a Social Security account number (or any derivative) is not displayed, coded, or embedded on an individual's Medicare card.


Legislative actions:
action_date: 2010-12-20
text: Referred to the Subcommittee on Commercial and Administrative Law.
action_date: 2010-12-20
text: Referred to the Subcommittee on Crime, Terrorism, and Homeland Security.
action_date: 2010-09-29
text: Referred to House Judiciary
action_date: 2010-09-29
text: Referred to House Ways and Means
action_date: 2010-09-29
text: 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 committee concerned.
action_date: 2010-09-29
text: Referred to House Energy and Commerce
action_date: 2010-09-29
text: Introduced in House
action_date: 2010-09-29
text: Introduced in House