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house Bill H.R. 5044

Medicare Fraud Enforcement and Prevention Act of 2010

Bill Details

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Medicare Fraud Enforcement and Prevention Act of 2010

Official Title

To provide for enhanced penalties to combat Medicare and Medicaid fraud, a Medicare data-mining system and biometric technology pilot program, and a GAO study on Medicare administrative contractors.


Medicare Fraud Enforcement and Prevention Act of 2010 - Amends title XI of the Social Security Act (SSA) to increase criminal penalties for both felony and misdemeanor fraud under SSA titles XVIII (Medicare) and XIX (Medicaid). Adds a new offense of distribution of two or more Medicare or Medicaid beneficiary identification numbers or billing privileges with the intent to defraud. Applies civil monetary penalties to: (1) conspiracy to make false statements or commit other specified offenses with respect to Medicare or Medicaid claims; and (2) knowing creation or use of false records or statements with respect to the transmission of money or property to a federal health care program. Extends the statute of limitations from six to 10 years after presentation of a claim. Amends SSA title XVIII (Medicare), as amended by the Patient Protection and Affordable Care Act (PPACA), to revise screening requirements. Amends SSA title XI, as amended by PPACA, to require the access to claims and payment data granted to Inspector General of the Department of Health and Human Services (HHS) and the Attorney General to include access to real time claims and payment data. Requires the HHS Inspector General to implement mechanisms for the sharing of information about suspected fraud relating to the federal health care programs under Medicare, Medicaid, and SSA title XXI (Children's Health Insurance Program) (CHIP) with other appropriate law enforcement officials. Directs the HHS Secretary to carry out a five-year pilot program that implements biometric technology to ensure that individuals entitled to benefits under Medicare part A or enrolled under Medicare part B are physically present at the time and place of receipt of certain items and services for which payment may be made. Requires the Comptroller General to study and report to Congress on Medicare administrative contractors, including Recovery Audit Contractors.

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      house Committees
      Committee on Energy and Commerce
      Committee on Ways and Means
    IntroducedApril 15th, 2010

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