Text: H.R.5120 — 102nd Congress (1991-1992)All Information (Except Text)

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Introduced in House

HR 5120 IH
2d Session
 H. R. 5120
To establish an Intergovernmental Commission on Health Care Fraud and Abuse.
May 7, 1992
Mr. WEISS introduced the following bill; which was referred jointly to the
Committees on Energy and Commerce, the Judiciary, and Ways and Means
To establish an Intergovernmental Commission on Health Care Fraud and Abuse.
  Be it enacted by the Senate and House of Representatives of the United
  States of America in Congress assembled,
  This Act may be cited as the `Intergovernmental Health Care Fraud and
  Abuse Commission Act of 1992'.
  (a) IN GENERAL- There is established a commission to be known as the
  `Intergovernmental Commission on Health Care Fraud and Abuse' (in this
  Act referred to as the `Commission').
  (b) COMPOSITION- The Commission shall be composed of 13 members as follows:
  (A) The Secretary of Health and Human Services (or the Secretary's designee).
  (B) The Inspector General of the Department of Health and Human Services
  (or the Inspector General's designee).
  (C) The Attorney General (or the Attorney General's designee).
  (D) The Director of the Federal Bureau of Investigation (or the Director's
  (E) The Administrator of the Health Care Financing Administration (or the
  Administrator's designee).
  (2) PUBLIC MEMBERS- Eight members, appointed by the President, of which--
  (A) one shall be an Attorney General of a State;
  (B) one shall be a representative of State medicaid fraud control programs;
  (C) one shall be a representative of health care consumers;
  (D) one shall be a representative of medicare beneficiaries;
  (E) one shall be a representative of physicians;
  (F) one shall be a representative of health insurance companies;
  (G) one shall be a representative of employers who provide employee health
  insurance; and
  (H) one shall be a representative of labor unions.
In making appointments under this paragraph of an individual who is a
representative of persons or organizations, the President shall consider
the recommendations of national organizations that represent such persons or
organizations. The President shall report to Congress, within 90 days after
the date of the enactment of this Act, the names of the members appointed
under this paragraph.
  (c) TERMS- Each member shall be appointed for the life of the Commission. A
  vacancy in the Commission shall be filled in the manner in which the
  original appointment was made.
  (a) IN GENERAL- The Commission shall--
  (1) investigate the nature, magnitude, and cost of health care fraud and
  abuse in the United States, and
  (2) identify and develop the most effective methods of preventing and
  eliminating such fraud and abuse, with particular emphasis on coordinating
  public and private prevention and enforcement efforts.
  (b) PARTICULARS- Among other items, the Commission shall examine at least
  the following:
  (1) Mechanisms to provide greater standardization of claims administration
  in order to accommodate fraud detection and prevention.
  (2) Mechanisms to allow more freedom of health benefit plans to exchange
  information for coordinating case development and prosecution efforts,
  without undermining patient and provider privacy protections or violating
  anti-trust laws.
  (3) The need for regulation of new types of health care providers.
  (4) Criteria for physician referrals to facilities in which they (or family
  members) have a financial interest.
  (5) The extension to private health insurers of administrative remedies
  currently available to public insurers.
  (6) Creating a model State statute for establishing State insurance fraud
  units and State laws to strengthen insurers' ability to pursue and recover
  from fraudulent providers.
  (7) The availability of resources to law enforcement authorities to combat
  health care fraud and abuse.
  (c) REPORT- After approval by a majority vote, a quorum being present,
  the Commission shall transmit to Congress a report on its activities
  to Congress. The report shall be transmitted not later than  18 months
  after the date that a majority of the public members of the Commission
  have been appointed. The report shall contain a detailed statement of the
  Commission's findings, together with such recommendations as the Commission
  considers appropriate.
  (1) RATES OF PAY- Each public member described in section 2(b)(2) who is not
  an officer or employee of the Federal Government is entitled to receive pay,
  subject to such amounts as are provided in advance in appropriation Acts,
  the daily equivalent of the minimum annual rate of basic pay in effect for
  grade GS-18 of the General Schedule for each day (including traveltime)
  during which the member is engaged in the actual performance of duties
  vested in the Commission. Each member of the Commission who is such an
  officer or employee shall serve without additional pay.
  (2) TRAVEL EXPENSES- While away from their homes or regular places of
  business in performance of services for the Commission, members of the
  Commission shall be allowed travel expenses, including per diem in lieu
  of subsistence, in accordance with sections 5702 and 5703 of title 5,
  United States Code.
  (1) QUORUM- Seven members of the Commission shall constitute a quorum but
  a lesser number may hold hearings.
  (2) CHAIRMAN- The chairman of the Commission shall be elected by the members.
  (3) MEETINGS- The Commission shall meet at the call of the chairman or
  a majority of its members. Meetings of the Commission are open to the
  public under section 10(a)(10) of the Federal Advisory Committee Act,
  except that the Commission may conduct meets in executive session but only
  if a majority of the members of the Commission (a quorum being present)
  approve going into executive session.
  (c) FUNDING- There are authorized to be appropriated to the Commission
  such funds as are necessary to carry out its functions. Such funds shall
  remain available until expended.
  (a) IN GENERAL; DETAIL OF FEDERAL EMPLOYEES- Subject to rules prescribed
  by the Commission, the chairman may appoint and fix the compensation of a
  staff director and such other additional personnel as may be necessary to
  enable the Commission to carry out its functions, without regard to the
  laws, rules, and regulations governing appointment and compensation and
  other conditions of service in the competitive service. Upon request of
  the chairman, any Federal employee who is subject to such laws, rules, and
  regulations, may be detailed to the Commission to assist it in carrying out
  its functions under this Act, and such detail shall be without interruption
  or loss of civil service status or privilege.
  (b) EXPERTS AND CONSULTANTS- The Commission may procure temporary and
  intermittent services under section 3109(b) of title 5, United States Code,
  but at rates for individuals not to exceed the daily equivalent of the
  minimum annual rate of basic pay payable for GS-18 of the General Schedule.
  (a) HEARINGS AND SESSIONS- The Commission may, for the purpose of carrying
  out this Act, hold hearings, sit and act at times and places, take testimony,
  and receive evidence as the Commission considers appropriate. The Commission
  may administer oaths or affirmations to witnesses appearing before it.
  (1) IN GENERAL- The Commission may secure directly from any department or
  agency of the United States information necessary to enable it to carry
  out this Act. Upon request of the chairman of the Commission, the head of
  that department or agency shall furnish that information to the Commission.
  (2) ACCESS TO INFORMATION- Information obtained by the Commission is
  available to the public in the same manner in which information may be
  made available under sections 552 and 552a of title 5, United States Code.
  (c) GIFTS, BEQUESTS, AND DEVISES- The Commission may accept, use, and
  dispose of gifts, bequests, or devises of services or property for the
  purpose of aiding or facilitating the work of the Commission.
  (d) MAILS- The Commission may use the United States mails in the same
  manner and under the same conditions as other departments and agencies of
  the United States.
  (e) ADMINISTRATIVE SUPPORT SERVICES- Upon the request of the Commission,
  the Administrator of General Services shall provide to the Commission,
  on a reimbursable basis, the administrative support services necessary
  for the Commission to carry out its responsibilities under this Act.
  (1) IN GENERAL- The Commission may issue subpoenas requiring the attendance
  and testimony of witnesses and the production of any evidence relating to
  any matter which the Commission is authorized to investigate under this
  Act. The attendance of witnesses and the production of evidence may be
  required from any place within the United States at any designated place
  of hearing within the United States.
  (2) FAILURE TO OBEY A SUBPOENA- If a person refuses to obey a subpoena issued
  under paragraph (1), the Commission may apply to a United States district
  court for an order requiring that person to appear before the Commission
  to give testimony, produce evidence, or both, relating to the matter under
  investigation. The application may be made within the judicial district
  where the hearing is conducted or where that person is found, resides,
  or transacts business. Any failure to obey the order of the court may be
  punished by the court as civil contempt.
  (3) SERVICE OF SUBPOENAS- The subpoenas of the Commission shall be served
  in the manner provided for subpoenas issued by a United States district
  court under the Federal Rules of Civil Procedure for the United States
  district courts.
  (4) SERVICE OF PROCESS- All process of any court to which application is
  to be made under paragraph (2) may be served in the judicial district in
  which the person required to be served resides or may be found.
  The Commission shall terminate 60 days after the date the report is
  submitted under section 3(c).

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