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1 H.R. 3245, Medicare Civil and Criminal Penalties Update Act 1 (2017)

handle is hein.congrec/marvcmp3948 and id is 1 raw text is: CONGRESSIONAL BUDGET OFFICE COST ESTIMATE November 9, 2017 H.R. 3245 Medicare Civil and Criminal Penalties Update Act As ordered reported by the House Committee on Energy and Commerce on October 4, 2017 SUMMARY H.R. 3245 would modify certain monetary penalties (both civil and criminal) for violations of federal law related to health care programs. CBO estimates that H.R. 3245 would not have a significant budgetary impact. Enacting H.R. 3245 could affect direct spending and revenues; therefore, pay-as-you-go procedures apply. CBO estimates that enacting H.R. 3245 would not have a significant effect on net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2028. H.R. 3245 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act (UMRA). BASIS OF ESTIMATE Under current law, the government may impose financial sanctions for violations of federal health care statutes.' For example, it is illegal to bill federal health care programs for services that were not provided or that were provided by unlicensed professionals. Those financial sanctions generally involve restitution-often between 150 percent and 300 percent of the amount that the federal government paid for illegally billed health care goods and services-and may involve an additional monetary penalty that may be assessed on a per-violation basis. The government may also exclude the perpetrator from participating in federal health care programs. Under current law, sections 1128A and 1128B of the Social Security Act establish penalties for each violation of not more than a specified amount-for example, not more than $10,000 for violations related to false 1. All penalties collected, both civil and criminal, are revenues and some result in new direct spending. Some penalties collected for violations that occurred in a state Medicaid program or in programs funded by the Maternal and Child Health Block Grant are returned to the states. Amounts paid to states or to other federal programs with the authority to spend them without further appropriations action would be direct spending.

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