Sober Home Fraud Detection Act

Bill: 115-hr-6092
Sponsor: full_name: Rep. Bilirakis, Gus M. [R-FL-12]
Introduced: 2018-06-13
Policy area: Health
Subjects: Drug, alcohol, tobacco use

Fraud offenses and financial crimes

Health facilities and institutions

Long-term, rehabilitative, and terminal care

Medical ethics

Medical tests and diagnostic methods
Latest action: action_date: 2018-06-13
text: Referred to the House Committee on Energy and Commerce.

Summaries:
action_date: 2018-06-13
action_desc: Introduced in House
text: <p><b>Sober Home Fraud Detection Act</b></p> <p>This bill requires the Department of Health and Human Services to publish common indicators of potentially fraudulent or disreputable recovery housing (alcohol- and drug-free shared living environments that promote recovery from substance use disorders), such as with respect to unusual billing practices, longer than average occupancies, and excessive levels of drug testing.</p>

tv_txt: I 115th CONGRESS 2d Session H. R. 6092 IN THE HOUSE OF REPRESENTATIVES June 13, 2018 Mr. Bilirakis (for himself, Mrs. Mimi Walters of California , Ms. Frankel of Florida , and Mr. Ruiz ) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To develop and identify indicators of potentially fraudulent and disreputable recovery housing operators, and for other purposes.

1. Short title This Act may be cited as the Sober Home Fraud Detection Act . 2. Best practices for identifying fraud in recovery housing practices (a) Definition In this Act, the term recovery housing means a shared living environment free from alcohol and illicit drug use and centered on peer support and connection to services that promote sustained recovery from substance use disorders. (b) Identification of fraudulent recovery housing operators (1) In General The Secretary of Health and Human Services (referred to in this Act as the Secretary ), in consultation with the individuals and entities described in paragraph (2), shall identify or facilitate the development of common indicators that could be used to identify potentially fraudulent or disreputable recovery housing operators. (2) Consultation In carrying out the activities described in paragraph (1), the Secretary shall consult with— (A) relevant divisions of the Department of Health and Human Services, including the Substance Abuse and Mental Health Services Administration, the Office of Inspector General, and the Centers for Medicare & Medicaid Services; (B) the Attorney General; (C) the Secretary of Housing and Urban Development; (D) State health departments, State Medicaid plans, and State insurance commissioners; (E) health insurance issuers; (F) national accrediting entities and reputable recovery housing operators; (G) the Government Accountability Office; and (H) other stakeholders identified by the Secretary. (c) Requirements (1) Practices for identification and reporting In carrying out the activities described in subsection (b), the Secretary shall consider how law enforcement, public and private payers, and the public can best identify and report fraudulent or disreputable recovery housing operators. (2) Factors to be considered In carrying out the activities described in subsection (b), the Secretary shall also consider identifying or developing indicators regarding— (A) unusual billing practices; (B) average lengths of patient stays that are longer than the norm; (C) excessive levels of drug testing (in terms of cost or volume); (D) unusually high levels of recidivism; (E) if the recovery housing operator is located in a geographic area identified by the Secretary as having a high level of health care fraud; and (F) any other factors identified by the Secretary. (d) Dissemination The Secretary shall make the indicators identified or developed under subsection (b) publicly available on the websites of the Department of Health and Human Services, the Department of Justice, and the Department of Housing and Urban Development, and shall disseminate the indicators identified or developed under subsection (b) to— (1) State agencies, which may include the provision of technical assistance to State agencies seeking to adopt or implement policies to better identify potentially fraudulent recovery housing operators; (2) health insurance issuers; (3) the Administrator of the Centers for Medicare & Medicaid Services; (4) the Secretary of Labor; (5) the Secretary of Housing and Urban Development; (6) State and local law enforcement agencies; and (7) the public, as appropriate. (e) Updates The Secretary shall update the indicators identified under this section as necessary. (f) Rule of construction Nothing in this section shall be construed to provide the Secretary with the ability to require States to adhere to minimum standards regarding State oversight of recovery housing.