There is one summary for H.R.3125. Bill summaries are authored by CRS.

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Introduced in House (03/20/1996)

TABLE OF CONTENTS:

Title I: Long-Term Care

Title II: Social Security Benefits

Title III: Independent Commission on Medicare

Title IV: Health Care Fraud Prevention

Subtitle A: All-Payer Fraud and Abuse Control Program

Subtitle B: Revisions to Current Sanctions for Fraud

and Abuse

Subtitle C: Administrative and Miscellaneous Provisions

Subtitle D: Civil Monetary Penalties

Subtitle E: Amendments to Criminal Law

Subtitle F: Payments for State Health Care Fraud

Control Units

Senior Citizens Bill of Rights Act of 1996 - Title I: Long-Term Care - Amends the Internal Revenue Code to: (1) provide for the treatment of qualified long-term care insurance as accident and health insurance for purposes of insurance company taxation; (2) exclude such insurance from cafeteria plans or flexible spending arrangements; (3) include amounts paid for qualified long-term care services as medical expenses for individual itemized deductions; (4) provide for the nonrecognition of gain or loss on the exchange of any life insurance contract or an endowment or annuity contract for a long-term care insurance contract; (5) exclude from gross income distributions from certain retirement plans for long-term care insurance; and (6) allow a $1,000 per qualified person tax credit for taxpayers who maintain a household which includes one or more qualified persons.

Title II: Social Security Benefits - Amends title II (Old-Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act to increase the monthly exempt amount, under the earnings test, for individuals who have attained retirement age. Sets forth a schedule of monthly adjustments increasing from $1,466 for taxable year 1997 to $4,166 for taxable year 2003.

(Sec. 202) Allows members of the clergy to revoke their exemption from social security coverage.

Title III: Independent Commission on Medicare - Establishes the Independent Commission on Medicare to: (1) report to the Congress and the President during December of each year on certain aspects of the Medicare program under title XVIII of the Social Security Act involving projected outlays and benefits; and (2) report to the Congress during July of each year specific recommendations on certain changes to ensure that total program outlays for the fiscal year involved do not exceed specified limits. Precludes such recommendations from including changes relating to the payment of payroll taxes for financing the program.

(Sec. 303) Provides procedures for expedited congressional consideration of recommendations.

(Sec. 305) Requires the Congress, not later than April 15 of each year, to establish, in the concurrent resolution on the budget for the fiscal year beginning on the following October 1, a limit on total outlays to be made under the Medicare program for the fiscal year.

(Sec. 306) Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to provide for the enforcement of such limits through sequestration.

Title IV: Health Care Fraud Prevention - Subtitle A: All-Payer Fraud and Abuse Control Program - Directs the Secretary of Health and Human Services to establish: (1) an all-payer fraud and abuse control program; and (2) standards, including information standards and disclosure standards, to carry out such program. Authorizes appropriations. Establishes, for such program, the Health Care Fraud and Abuse Account (the Account), which shall consist of gifts, bequests, deposits, and transfers under certain health care offenses provisions of specified Acts.

(Sec. 402) Provides for the application to any health plan of specified health anti-fraud and abuse provisions of part A (General Provisions) of title XI of the Social Security Act.

(Sec. 403) Directs the Secretary to solicit proposals annually for modification of, and to modify, existing safe harbor rules. Permits any individual, at any time, to request a notice from the Inspector General (IG) informing the public of practices which the IG considers to be suspect or of particular concern.

(Sec. 404) Directs the Secretary to establish a program through which individuals entitled to Medicare benefits may confidentially report instances of suspected fraud.

Subtitle B: Revisions to Current Sanctions for Fraud and Abuse - Amends titles XI (General Provisions and Peer Review) and XVIII (Medicare) of the Social Security Act to: (1) provide for mandatory exclusion of individuals with a felony fraud conviction from participation in Medicare and State health care programs; (2) establish a minimum period of exclusion for certain individuals and entities subject to permissive exclusion from Medicare and State health care programs; (3) provide for the permissive exclusion of individuals with ownership or control interest in sanctioned activities; (4) provide for a minimum period of exclusion for practitioners and individuals failing to meet statutory obligations; and (5) intermediate sanctions for Medicare health maintenance organizations.

Subtitle C: Administrative and Miscellaneous Provisions - Directs the Secretary to provide for the establishment of a national health care fraud and abuse data collection program for the reporting of final adverse actions against health care providers, suppliers, or practitioners.

Subtitle D: Civil Monetary Penalties - Provides, under part A of title XI of the Social Security Act, for: (1) the payment of the portion of amounts recovered under this Act into the Account; and (2) an increase in the civil monetary penalty. Subjects to such penalty an excluded individual retaining an ownership or controlling interest of five percent or more in a Medicare or State health care program. Permits the Secretary to impose a $10,000 penalty, plus a special assessment, on any individual (including any organization, but excluding a beneficiary) who knowingly violates the prohibition against illegal remunerations.

Subtitle E: Amendments to Criminal Law - Amends the Federal criminal code to: (1) impose a fine or imprisonment for up to ten years or both in the case of health care mail fraud; (2) provide for the forfeiture of property for certain Federal health care offenses; (3) provide for specified injunctive relief; (4) provide for fines or imprisonment or both in connection with Federal health care offenses; (5) establish a voluntary disclosure program in connection with Federal health care offenses; and (6) establish penalties for obstruction of criminal investigations of Federal health care offenses, theft or embezzlement in connection with health care, and the laundering of monetary instruments in connection with a Federal health care offense.

Subtitle F: Payments for State Health Care Fraud Control Units - Directs the Governor of each State to establish and maintain a State agency to act as a State Health Care Fraud and Abuse Control Unit. Provides for specified Federal payments to the States for such agencies.