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H.R. 3200/Division B/Title VI

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Title V
—Medicare Graduate Medical Education
America's Affordable Health Choices Act of 2009
Division B - Medicare and Medicaid Improvements
Title VI - Program Integrity
Title VII—
Medicaid and CHIP
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TITLE VI — PROGRAM INTEGRITY

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Subtitle A—Increased Funding to Fight Waste, Fraud, and Abuse
Sec. 1601. Increased Funding and Flexibility to Fight Fraud and Abuse.
Subtitle B—Enhanced Penalties for Fraud and Abuse
Sec. 1611. Enhanced Penalties for False Statements on Provider or Supplier Enrollment Applications.
Sec. 1612. Enhanced Penalties for Submission of False Statements Material to a False Claim.
Sec. 1613. Enhanced Penalties for Delaying Inspections.
Sec. 1614. Enhanced Hospice Program Safeguards.
Sec. 1615. Enhanced Penalties for Individuals Excluded from Program Participation.
Sec. 1616. Enhanced Penalties for Provision of False Information by Medicare Advantage and PART D Plans.
Sec. 1617. Enhanced Penalties for Medicare Advantage and PART D Marketing Violations.
Sec. 1618. Enhanced Penalties for Obstruction of Program Audits.
Sec. 1619. Exclusion of Certain Individuals and Entities from Participation in Medicare and State Health Care Programs.
Subtitle C—Enhanced Program and Provider Protections
Sec. 1631. Enhanced CMS Program Protection Authority.
Sec. 1632. Enhanced Medicare, Medicaid, and CHIP Program Disclosure Requirements Relating to Previous Affiliations.
Sec. 1633. Required Inclusion of Payment Modifier for Certain Evaluation and Management Services.
Sec. 1634. Evaluations and Reports Required under Medicare Integrity Program.
Sec. 1635. Require Providers and Suppliers to Adopt Programs to Reduce Waste, Fraud, and Abuse.
Sec. 1636. Maximum Period for Submission of Medicare Claims Reduced to Not More Than 12 Months.
Sec. 1637. Physicians Who Order Durable Medical Equipment or Home Health Services Required to be Medicare Enrolled Physicians or Eligible Professionals.
Sec. 1638. Requirement for Physicians to Provide Documentation on Referrals to Programs at High Risk of Waste and Abuse.
Sec. 1639. Face to Face Encounter with Patient Required Before Physicians May Certify Eligibility for Home Health Services or Durable Medical Equipment Under Medicare.
Sec. 1640. Extension of Testimonial Subpoena Authority to Program Exclusion Investigations.
Sec. 1641. Required Repayments of Medicare and Medicaid Overpayments.
Sec. 1642. Expanded Application of Hardship Waivers for OIG Exclusions to Beneficiaries of Any Federal Health Care Program.
Sec. 1643. Access to Certain Information on Renal Dialysis Facilities.
Sec. 1644. Billing Agents, Clearinghouses, or Other Alternate Payees Required to Register under Medicare.
Sec. 1645. Conforming Civil Monetary Penalties to False Claims Act Amendments.
Subtitle D—Access to Information Needed To Prevent Fraud, Waste, and Abuse
Sec. 1651. Access to Information Necessary to Identify Fraud, Waste, and Abuse.
Sec. 1652. Elimination of Duplication Between the Healthcare Integrity and Protection Data Bank and the National Practitioner Data Bank.
Sec. 1653. Compliance with HIPAA Privacy and Security Standards.



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