MEDICARE-MEDICAID ANTI-FRAUD AND ABUSE AMENDMENTS OF 1977 - REPORT OF THE SENATE COMMITTEE ON FINANCE ON S 143, SEPTEMBER 26, 1977

• NCJ Number: 48148
• Author(s): ANON
• Date Published: 1977
• Length: 100 pages
• Corporate Author: US Congress
• Sale Source: National Institute of Justice/; US Congress
• Language: English
• Country: United States of America
• Note: 95 TH CONGRESS, 1ST SESSION

Annotation

COMMITTEE FINDINGS RELATIVE TO THE RECOMMENDATION THAT THE BILL IN QUESTION BE PASSED IN AMENDED FORM ARE DOCUMENTED.

Abstract

THE PROVISIONS OF THE MEDICARE-MEDICAID ANTI-FRAUD AND ABUSE AMENDMENTS OF 1977 FOCUS ON THE FOLLOWING AREAS: STRENGTHENED PROGRAM PENALTY SANCTIONS; INCREASED DISCLOSURE OF INFORMATION; NEEDED IMPROVEMENTS IN THE PROFESSIONAL STANDARDS REVIEW PROGRAM; ADMINISTRATIVE REFORMS; AND OTHER AMENDMENTS. THE PRINCIPAL FEATURES OF THE BILL AS REPORTED BY THE COMMITTEE ARE OUTLINED. A GENERAL EXPLANATION OF THE BILL COVERS PROHIBITION AGAINST ASSIGNMENT BY PHYSICIANS AND OTHERS OF CLAIM FOR SERVICES, CLAIMS PAYMENT PROCEDURES FOR MEDICAID, DISCLOSURE OF PROVIDER OWNERSHIP AND FINANCIAL INFORMATION, PENALTIES FOR DEFRAUDING MEDICARE AND MEDICAID, AMENDMENTS RELATED TO PROFESSIONAL STANDARDS REVIEW ORGANIZATIONS, SUSPENSION OF PRACTITIONERS CONVICTED OF MEDICARE- OR MEDICAID-RELATED CRIMES, AND DISCLOSURES BY SERVICE PROVIDERS OF OWNERS WHO HAVE BEEN CONVICTED OF FRAUD. ALSO DESCRIBED ARE BILL PROVISIONS RELATED TO FEDERAL ACCESS TO RECORDS, CLAIMS-PROCESSING AND INFORMATION RETRIEVAL SYSTEMS IN MEDICAID PROGRAMS, RESTRICTIONS ON FEDERAL MEDICAID PAYMENTS, FUNDING OF STATE MEDICAID FRAUD CONTROL UNITS, PROSECUTION OF CIVIL FRAUD, AND OTHER MATTERS. ESTIMATES OF THE COST OF CARRYING OUT THE BILL AND OF THE REGULATORY IMPACT OF THE BILL ARE PRESENTED, TOGETHER WITH DOCUMENTATION OF CHANGES IN EXISTING LAWS THAT WOULD RESULT FROM PASSAGE OF THE BILL.