HR6108-119

1. Making certain exclusions from participation in Federal health care programs related to fraud mandatory Section 1128 of the Social Security Act (42 U.S.C. 1320a–7) is amended— in subsection (a), by adding at the end the following new paragraphs: Any individual or entity that has been convicted for an offense which occurred on or after the date that is 1 year after the date of the enactment of this paragraph, under Federal or State law— of a criminal offense consisting of a misdemeanor relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct— in connection with the delivery of a health care item or service, or with respect to any act or omission in a health care program (other than those specifically described in paragraph (1)) operated by or financed in whole or in part by any Federal, State, or local government agency; or of a criminal offense relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct with respect to any act or omission in a program (other than a health care program) operated by or financed in whole or in part by any Federal, State, or local government agency. Any individual or entity that the Secretary determines has committed an act which is described in section 1128A, 1128B, or 1129 on or after the date that is 1 year after the date of the enactment of this paragraph. in subsection (b)— in paragraph (1), by inserting and before the date that is 1 year after the date of the enactment of subsection (a)(5) before , under Federal or State law; and in paragraph (7), by inserting before the date that is 1 year after the date of the enactment of subsection (a)(6) before the period at the end; and in subsection (f)(2), by inserting (a)(6) or after subsection each place it appears. Section 1128D(a)(1)(A)(ii) of the Social Security Act (42 U.S.C. 1320a–7d(a)(1)(A)(ii)) is amended by striking section 1128(b)(7) and inserting subsection (a)(6) or (b)(7) of section 1128. (5) Conviction relating to fraud Any individual or entity that has been convicted for an offense which occurred on or after the date that is 1 year after the date of the enactment of this paragraph, under Federal or State law— (A) of a criminal offense consisting of a misdemeanor relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct— (i) in connection with the delivery of a health care item or service, or (ii) with respect to any act or omission in a health care program (other than those specifically described in paragraph (1)) operated by or financed in whole or in part by any Federal, State, or local government agency; or (B) of a criminal offense relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct with respect to any act or omission in a program (other than a health care program) operated by or financed in whole or in part by any Federal, State, or local government agency. (6) Fraud, kickbacks, and other prohibited activities Any individual or entity that the Secretary determines has committed an act which is described in section 1128A, 1128B, or 1129 on or after the date that is 1 year after the date of the enactment of this paragraph. ;