“A bill to increase the penalties for health care fraud, and for other purposes.”
No CRS summary available for this bill.
This section increases the maximum term of imprisonment for health care fraud to 25 years (from 10 years) and, if the violation results in serious bodily injury, to 30 years (from 20 years). The amendments apply to acts occurring on or after the date of enactment.
This section increases criminal fines and imprisonment terms under Section 1128B of the Social Security Act, which prohibits kickbacks, bribes, rebates, and other fraud involving federal health care programs (e.g., Medicare, Medicaid), as follows: (1) to $250,000 (from $100,000) each place it appears; (2) to 25 years (from 10 years) each place it appears; (3) in subsection (a), to $100,000 (from $20,000) in the flush matter following paragraph (6); and (4) in subsection (e), to $100,000 (from $4,000) and to 1 year (from six months). The amendments apply to acts occurring and statements or representations made on or after the date of enactment.
This section directs the United States Sentencing Commission, pursuant to 28 U.S.C. 994(p), to review and, if appropriate, amend its sentencing guidelines and policy statements applicable to persons convicted of covered offenses, defined as health care fraud under 18 U.S.C. 1347 (i.e., schemes to defraud health care benefit programs, punishable by up to 10 years imprisonment, 20 years if serious bodily injury results, or life if death results) or offenses under section 1128B of the Social Security Act (42 U.S.C. 1320a-7b) (i.e., fraud, false statements, or kickbacks involving federal health care programs). In doing so, the Commission must (1) ensure the guidelines reflect the seriousness of covered offenses, their growing incidence, and the need for effective deterrence and appropriate punishment; (2) consider factors such as potential and actual loss (including qualitative victim impact), sophistication and planning, commercial or financial motives, intent or effect to cause physical/psychological/emotional harm or disclose personal health information, threats to public health or safety, and the defendant's role and offense duration; (3) ensure reasonable consistency with other guidelines and directives; (4) account for additional aggravating or mitigating circumstances; (5) make conforming changes; and (6) meet the purposes of sentencing under 18 U.S.C. 3553(a)(2).