STRENGTHENING THE HEALTH CARE FRAUD PREVENTION TASK FORCE ACT OF 2019; Congressional Record Vol. 165, No. 34
(House of Representatives - February 25, 2019)

Text available as:

Formatting necessary for an accurate reading of this text may be shown by tags (e.g., <DELETED> or <BOLD>) or may be missing from this TXT display. For complete and accurate display of this text, see the PDF.


[Pages H2053-H2055]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  1645
 STRENGTHENING THE HEALTH CARE FRAUD PREVENTION TASK FORCE ACT OF 2019

  Mr. ENGEL. Mr. Speaker, I move to suspend the rules and pass the bill 
(H.R. 525) to amend title XI of the Social Security Act to direct the 
Secretary of Health and Human Services to establish a public-private 
partnership for purposes of identifying health care waste, fraud, and 
abuse.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 525

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Strengthening the Health 
     Care Fraud Prevention Task Force Act of 2019''.

[[Page H2054]]

  


     SEC. 2. PUBLIC-PRIVATE PARTNERSHIP FOR HEALTH CARE WASTE, 
                   FRAUD, AND ABUSE DETECTION.

       (a) In General.--Section 1128C(a) of the Social Security 
     Act (42 U.S.C. 1320a-7c(a)) is amended by adding at the end 
     the following new paragraph:
       ``(6) Public-private partnership for waste, fraud, and 
     abuse detection.--
       ``(A) In general.--Under the program described in paragraph 
     (1), there is established a public-private partnership (in 
     this paragraph referred to as the `partnership') of health 
     plans, Federal and State agencies, law enforcement agencies, 
     health care anti-fraud organizations, and any other entity 
     determined appropriate by the Secretary (in this paragraph 
     referred to as `partners') for purposes of detecting and 
     preventing health care waste, fraud, and abuse.
       ``(B) Contract with trusted third party.--In carrying out 
     the partnership, the Secretary shall enter into a contract 
     with a trusted third party for purposes of carrying out the 
     duties of the partnership described in subparagraph (C).
       ``(C) Duties of partnership.--The partnership shall--
       ``(i) provide technical and operational support to 
     facilitate data sharing between partners in the partnership;
       ``(ii) analyze data so shared to identify fraudulent and 
     aberrant billing patterns;
       ``(iii) conduct aggregate analyses of health care data so 
     shared across Federal, State, and private health plans for 
     purposes of detecting fraud, waste, and abuse schemes;
       ``(iv) identify outlier trends and potential 
     vulnerabilities of partners in the partnership with respect 
     to such schemes;
       ``(v) refer specific cases of potential unlawful conduct to 
     appropriate governmental entities;
       ``(vi) convene, not less than annually, meetings with 
     partners in the partnership for purposes of providing updates 
     on the partnership's work and facilitating information 
     sharing between the partners;
       ``(vii) enter into data sharing and data use agreements 
     with partners in the partnership in such a manner so as to 
     ensure the partnership has access to data necessary to 
     identify waste, fraud, and abuse while maintaining the 
     confidentiality and integrity of such data;
       ``(viii) provide partners in the partnership with plan-
     specific, confidential feedback on any aberrant billing 
     patterns or potential fraud identified by the partnership 
     with respect to such partner;
       ``(ix) establish a process by which entities described in 
     subparagraph (A) may enter the partnership and requirements 
     such entities must meet to enter the partnership;
       ``(x) provide appropriate training, outreach, and education 
     to partners based on the results of data analyses described 
     in clauses (ii) and (iii); and
       ``(xi) perform such other duties as the Secretary 
     determines appropriate.
       ``(D) Substance use disorder treatment analysis.--Not later 
     than 2 years after the date of the enactment of the 
     Strengthening the Health Care Fraud Prevention Task Force Act 
     of 2019, the trusted third party with a contract in effect 
     under subparagraph (B) shall perform an analysis of aberrant 
     or fraudulent billing patterns and trends with respect to 
     providers and suppliers of substance use disorder treatments 
     from data shared with the partnership.
       ``(E) Executive board.--
       ``(i) Executive board composition.--

       ``(I) In general.--There shall be an executive board of the 
     partnership comprised of representatives of the Federal 
     Government and representatives of the private sector selected 
     by the Secretary.
       ``(II) Chairs.--The executive board shall be co-chaired by 
     one Federal Government official and one representative from 
     the private sector.

       ``(ii) Meetings.--The executive board of the partnership 
     shall meet at least once per year.
       ``(iii) Executive board duties.--The duties of the 
     executive board shall include the following:

       ``(I) Providing strategic direction for the partnership, 
     including membership criteria and a mission statement.
       ``(II) Communicating with the leadership of the Department 
     of Health and Human Services and the Department of Justice 
     and the various private health sector associations.

       ``(F) Reports.--Not later than September 30, 2021, and 
     every 2 years thereafter, the Secretary shall submit to 
     Congress and make available on the public website of the 
     Centers for Medicare & Medicaid Services a report 
     containing--
       ``(i) a review of activities conducted by the partnership 
     over the 2-year period ending on the date of the submission 
     of such report, including any progress to any objectives 
     established by the partnership;
       ``(ii) any savings voluntarily reported by health plans 
     participating in the partnership attributable to the 
     partnership during such period;
       ``(iii) any savings to the Federal Government attributable 
     to the partnership during such period;
       ``(iv) any other outcomes attributable to the partnership, 
     as determined by the Secretary, during such period; and
       ``(v) a strategic plan for the 2-year period beginning on 
     the day after the date of the submission of such report, 
     including a description of any emerging fraud and abuse 
     schemes, trends, or practices that the partnership intends to 
     study during such period.
       ``(G) Funding.--The partnership shall be funded by amounts 
     otherwise made available to the Secretary for carrying out 
     the program described in paragraph (1).
       ``(H) Transitional provisions.--To the extent consistent 
     with this subsection, all functions, personnel, assets, 
     liabilities, and administrative actions applicable on the 
     date before the date of the enactment of this paragraph to 
     the National Fraud Prevention Partnership established on 
     September 17, 2012, by charter of the Secretary shall be 
     transferred to the partnership established under subparagraph 
     (A) as of the date of the enactment of this paragraph.
       ``(I) Nonapplicability of faca.--The provisions of the 
     Federal Advisory Committee Act shall not apply to the 
     partnership established by subparagraph (A).
       ``(J) Implementation.--Notwithstanding any other provision 
     of law, the Secretary may implement the partnership 
     established by subparagraph (A) by program instruction or 
     otherwise.
       ``(K) Definition.--For purposes of this paragraph, the term 
     `trusted third party' means an entity that--
       ``(i) demonstrates the capability to carry out the duties 
     of the partnership described in subparagraph (C);
       ``(ii) complies with such conflict of interest standards 
     determined appropriate by the Secretary; and
       ``(iii) meets such other requirements as the Secretary may 
     prescribe.''.
       (b) Potential Expansion of Public-Private Partnership 
     Analyses.--Not later than 2 years after the date of the 
     enactment of this Act, the Secretary of Health and Human 
     Services shall conduct a study and submit to Congress a 
     report on the feasibility of the partnership (as described in 
     section 1128C(a)(6) of the Social Security Act, as added by 
     subsection (a)) establishing a system to conduct real-time 
     data analysis to proactively identify ongoing as well as 
     emergent fraud trends for the entities participating in the 
     partnership and provide such entities with real-time feedback 
     on potentially fraudulent claims. Such report shall include 
     the estimated cost of and any potential barriers to the 
     partnership establishing such a system.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
York (Mr. Engel) and the gentleman from Ohio (Mr. Latta) each will 
control 20 minutes.
  The Chair recognizes the gentleman from New York.


                             General Leave

  Mr. ENGEL. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
include extraneous material on H.R. 525.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New York?
  There was no objection.
  Mr. ENGEL. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 525, the Strengthening 
the Health Care Fraud Prevention Task Force Act of 2019. This 
bipartisan bill would authorize the Healthcare Fraud Prevention 
Partnership, and improve and expand the task force's ability to fight 
waste, fraud, and abuse throughout our healthcare system.
  The Healthcare Fraud Prevention Partnership is a public-private 
partnership between the Department of Health and Human Services, 
insurance companies, Federal and State law enforcement agencies, and 
State healthcare agencies. The partnership aims to improve the 
detection and prevention of healthcare fraud by facilitating the 
exchange of data and information between the public and private sectors 
on fraud trends and successful antifraud practices.
  The legislation we are considering today would authorize the 
partnership, require the partnership to report regularly to Congress, 
and give the agency new tools to enhance and expand its capabilities.
  We must continue to work on a bipartisan basis to enhance our fraud 
detection capabilities.
  I support this legislation and I urge my colleagues to continue to 
work together to find meaningful solutions to root out fraud, waste, 
and abuse in our healthcare system.
  Mr. Speaker, I reserve the balance of my time.
                                         House of Representatives,


                                  Committee on Ways and Means,

                                Washington, DC, February 25, 2019.
     Hon. Frank Pallone,
     Chairman, Energy and Commerce Committee,
     Washington, DC.
       Dear Chairman Pallone: In recognition of the desire to 
     expedite consideration of H.R. 525, Strengthening the Health 
     Care Fraud Prevention Task Force Act of 2019, the Committee 
     on Ways and Means agrees to waive formal consideration of the 
     bill as to provisions that fall within the rule X 
     jurisdiction of the Committee on Ways and Means.

[[Page H2055]]

       The Committee on Ways and Means takes this action with the 
     mutual understanding that we do not waive any jurisdiction 
     over the subject matter contained in this or similar 
     legislation, and the Committee will be appropriately 
     consulted and involved as the bill or similar legislation 
     moves forward so that we may address any remaining issues 
     within our jurisdiction. The Committee also reserves the 
     right to seek appointment of an appropriate number of 
     conferees to any House-Senate conference involving this or 
     similar legislation.
       Finally, I would appreciate your response to this letter 
     confirming this understanding, and would ask that a copy of 
     our exchange of letter on this matter be included in the 
     Congressional Record during floor consideration of H.R. 525.
           Sincerely,
                                                  Richard E. Neal,
     Chairman.
                                  ____

                                         House of Representatives,


                             Committee on Energy and Commerce,

                                Washington, DC, February 25, 2019.
     Hon. Richard E. Neal,
     Chairman, Ways and Means,
     Washington, DC.
       Dear Chairman Neal: Thank you for consulting with the 
     Committee on Energy and Commerce and agreeing to discharge 
     H.R. 525, Strengthening the Health Care Fraud Prevention Task 
     Force Act of 2019 from further consideration, so that the 
     bill may proceed expeditiously to the House floor.
       I agree that your forgoing further action on this measure 
     does not in any way diminish or alter the jurisdiction of 
     your committee or prejudice its jurisdictional prerogatives 
     on this measure or similar legislation in the future. I would 
     support your effort to seek appointment of an appropriate 
     number of conferees from your committee to any House-Senate 
     conference on this legislation.
       I will ensure our letters on H.R. 525 are entered into the 
     Congressional Record during floor consideration of the bill. 
     I appreciate your cooperation regarding this legislation and 
     look forward to continuing to work together as this measure 
     moves through the legislative process.
           Sincerely,
                                               Frank Pallone, Jr.,
                                                         Chairman.

  Mr. LATTA. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 525, the Strengthening the 
Health Care Fraud Prevention Task Force Act of 2019, introduced by the 
Energy and Commerce Committee Republican Leader Walden and Chairman 
Pallone.
  This legislation will codify the Healthcare Fraud Prevention 
Partnership, which is currently operated by the Centers for Medicare 
and Medicaid Services and is a voluntary public-private partnership 
between the Federal Government, State agencies, law enforcement, 
private health insurance plans, and healthcare antifraud associations.
  The partnership was established by the Obama administration and the 
Trump administration recommended codifying it, solidifying the 
bipartisan nature of revealing and halting scams that cut across public 
and private payers.
  H.R. 525 will ensure the continued operation of this important 
partnership to detect and prevent healthcare fraud through public-
private information sharing, streamlining analytical tools and data, 
and providing a forum for government and industry experts to exchange 
successful antifraud practices.
  This bill before us today is the product of bipartisan cooperation, 
as well as engagement with the Department of Health and Human Services 
and industry stakeholders.
  Originally introduced in the 115th Congress, this legislation worked 
its way through the Committee on Energy and Commerce in a transparent 
manner and currently enjoys the support of the chairmen and republican 
leaders of both the Committee of Energy and Commerce and the Committee 
on Ways and Means.
  Mr. Speaker, I urge passage of this bill, and I yield back the 
balance of my time.
  Mr. ENGEL. Mr. Speaker, I urge my colleagues to work together to find 
meaningful solutions to root out waste, fraud, and abuse in our 
healthcare system, and I yield back the balance of my time.
  Mr. WALDEN. Mr. Speaker, I rise today in support of H.R. 525, the 
Health Care Fraud Prevention Task Force Act.
  This bipartisan bill--which I introduced with Chairman Frank Pallone, 
and which is supported by Ways and Means Chairman Richard Neal and 
Republican Leader Kevin Brady--is a commonsense, bipartisan bill to 
improve the integrity of our nation's health care system.
  The Centers for Medicare and Medicaid Services (CMS) currently 
operates the Health Care Fraud Prevention Partnership--a voluntary 
collaboration between the federal government, state agencies, law 
enforcement, private health insurance plans, and anti-fraud 
associations. Together, this group works to detect and prevent fraud 
that threatens to undermine our nation's health care system. This 
program was created by the Obama Administration, and the Trump 
Administration has recommended codifying it into law. The bill before 
us today does just that.
  Mr. Speaker, last Congress, the House passed this legislation by 
voice vote but unfortunately, we were unable to get this bill through 
the Senate and to the President's desk before the end of the Congress.
  In fact, the House Energy and Commerce Committee had 148 bills pass 
the House last Congress, and 93 percent of them received bipartisan 
votes. I'd like to thank Chairman Pallone for continuing in that 
bipartisan spirit by helping to bring this bill back to the floor 
today.
  I urge passage of H.R. 525.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New York (Mr. Engel) that the House suspend the rules 
and pass the bill, H.R. 525.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

                          ____________________