,i #aaeth ,,congress #ast ,session ,h4 ,r4 #cagc ,,in ,,the ,,house ,,of ,,representatives ,july #aj1 #bjag,mr4 ,marchant 7for himself1 ,mr4 ,kind1 and ,mr4 ,meehan7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,ways and ,means1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to create alternative sanctions for technical noncompliance with the ,stark rule under ,medicare1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,stark ,administrative ,simplification ,act of #bjag4 #b4 ,alternative sanctions for technical noncompliance with ,stark rule under ,medicare ,section #ahgg7;g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acienn7g77 is amended-- 7#a7 in paragraph 7#a71 by striking ,no and inserting ,subject to paragraph 7#g71 no2 7#b7 in paragraph 7#b71 by striking ,if and inserting ,subject to paragraph 7#g71 if2 7#c7 in paragraph 7#c71 by striking ,any and inserting ,subject to paragraph 7#g71 any2 and 7#d7 by adding at the end the following new paragraph3 7#g7 ,alternative sanctions for technical noncompliance 7,a7 ,single penalty for compensation arrangements in technical noncompliance ,in the case of a compensation arrangement between a physician 7or an immediate family member of such physician7 and a person or entity that is in violation of subsection 7a77#a7 solely due to technical noncompliance1 instead of the sanctions described in paragraphs 7#a71 7#b71 and 7#c7 for any such violation1 the person or entity with respect to such arrangement shall be subject to a single civil monetary penalty under this paragraph in an amount that does not exceed-- 7i7 in the case in which the disclosure of the violation is submitted to the ,secretary not later than the date that is one year after the initial date of noncompliance1 #e1jjj2 and 7ii7 in the case in which the disclosure of the violation is submitted to the ,secretary after the date that is one year after the initial date of noncompliance1 #aj1jjj4 7,b7 ,acceptance of voluntary disclosures 7i7 ,in general ,beginning as of the date of the enactment of this paragraph1 the ,secretary shall accept the voluntary disclosure of a technically noncompliant compensation arrangement if such voluntary disclosure is made as described in clause 7iii74 ,the ,secretary may accept and reasonably rely on information provided by a person or entity that is in violation of subsection 7a77#a7 only because of a compensation arrangement that is technically noncompliant4 7ii7 ,acceptance of disclosure ,the ,secretary may reject any voluntary disclosure submitted under clause 7iii7 within #ij days after the receipt of the disclosure only if the ,secretary determines that the disclosure does not conform to the requirements described in clause 7iii74 ,if the ,secretary fails to reject a voluntary disclosure within such #ij-;day period1 the voluntary disclosure is deemed to be accepted4 7iii7 ,voluntary disclosure ,a voluntary disclosure described in this clause is a disclosure concerning a compensation arrangement that is submitted to the ,secretary by a party to such arrangement that contains the following3 7,i7 ,the identification of the disclosing party and all other parties to the disclosed compensation arrangement4 7,,ii7 ,a description of the compensation paid under the arrangement and the dates of noncompliance4 7,,iii7 ,a certification by the disclosing party that the compensation arrangement satisfies the requirements described in clause 7v74 7,,iv7 ,payment for the full amount of the civil monetary penalty under clause 7i7 or 7ii71 as applicable1 of subparagraph 7,a74 7iv7 ,settlement of liability and payment of claims ,a voluntary disclosure of a technically noncompliant compensation arrangement that is made and accepted under this subparagraph shall constitute a full and complete settlement of liability under this subsection to the extent such liability is with respect to such technically noncompliant compensation arrangement4 ,any bill or claim for payment related to a technically noncompliant compensation arrangement shall not be subject to the sanctions under this subsection and shall be payable after a voluntary disclosure is made as described in clause 7iii74 7v7 ,compensation arrangement requirements ,for purposes of clause 7iii77,,iii71 the requirements described in this clause1 with respect to a compensation arrangement1 are the following3 7,i7 ,the compensation arrangement is technically noncompliant 7as defined by subparagraph 7,c774 7,,ii7 ,the compensation arrangement has been cured of the technical noncompliance1 or is otherwise terminated4 7,,iii7 ,in the case of technical noncompliance described in subparagraph 7,c77i71 the compensation arrangement is consistent with fair market value1 and the remuneration under the arrangement is not determined in a manner that takes into account directly or indirectly the volume or value of any referrals4 7,c7 ,definition technical noncompliance ,for purposes of this paragraph1 the term technical noncompliance means1 with respect to a compensation arrangement1 such an arrangement that is in violation of subsection 7a77#a7 only because-- 7i7 the arrangement is not set forth in writing2 7ii7 the arrangement is not signed by one or more parties to the arrangement2 or 7iii7 the arrangement became in violation of such subsection by reason of its expiration4 7,d7 ,applicability to pre-enactment disclosures to relieve backlog ,in addition to the application of this paragraph to technically noncompliant compensation arrangements disclosed on or after the date of the enactment of this paragraph1 the ,secretary shall provide for the application of this paragraph to any technically noncompliant compensation arrangement that has been disclosed1 and to which there has not been a final settlement1 as of the date of enactment of this paragraph4 7,e7 ,report ,not later than #bd months after the date of enactment of this paragraph1 the ,administrator of the ,centers for ,medicare ,medicaid ,services shall submit to ,congress a report on the implementation of this paragraph4 ,such report shall include-- 7i7 the number of persons or entities making disclosures of technical noncompliance under this paragraph2 7ii7 the amount and type of alternative sanctions collected or imposed for technical noncompliance2 7iii7 the types of violations disclosed2 and 7iv7 such other information as the ,inspector ,general determines may be necessary to evaluate the impact of this paragraph4 4 #c4 ,clarification of the writing requirement and signature requirement for arrangements pursuant to the ,stark rule under ,medicare 7a7 ,writing requirement ,section #ahgg7;h77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acienn7h77#a77 is amended by adding at the end the following new subparagraph3 7,d7 ,written requirement clarified ,in the case of any requirement pursuant to this section for a compensation arrangement to be in writing1 such requirement shall be satisfied by such means as determined by the ,secretary1 including by a collection of documents1 including contemporaneous documents evidencing the course of conduct between the parties involved4 4 7b7 ,signature requirement ,section #ahgg7;e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acienn7e77 is amended-- 7#a7 in paragraph 7#a77;,a77i71 by inserting before or not later than #ij days after the effective date of the lease after signed by the parties2 7#b7 in paragraph 7#a77;,b77i71 by inserting before or not later than #ij days after the effective date of the lease after signed by the parties2 and 7#c7 in paragraph 7#c77;,a77i71 by inserting before or not later than #ij days after the effective date of the arrangement after signed by the parties4 #d4 ,indefinite holdover for lease arrangements and personal services arrangements pursuant to the ,stark rule under ,medicare ,section #ahgg of the ,social ,security ,act 7#db ,u4,s4,c4 #acienn7 is amended-- 7#a7 in subsection 7e7-- 7,a7 in paragraph 7#a71 by adding at the end the following new subparagraph3 7,c7 ,holdover lease arrangements ,in the case of a holdover lease arrangement for the lease of office space or equipment1 which immediately follows a lease arrangement described in subparagraph 7,a7 for the use of such office space or subparagraph 7,b7 for the use of such equipment and that expired after a term of at least one year1 payments made by the lessee to the lessor pursuant to such holdover lease arrangement1 if-- 7i7 the lease arrangement met the conditions of subparagraph 7,a7 for the lease of office space or subparagraph 7,b7 for the use of equipment when the arrangement expired2 7ii7 the holdover lease arrangement is on the same terms and conditions as the immediately preceding arrangement2 and 7iii7 the holdover arrangement continues to satisfy the conditions of subparagraph 7,a7 for the lease of office space or subparagraph 7,b7 for the use of equipment4 2 and 7,b7 in paragraph 7#c71 by adding at the end the following new subparagraph3 7,c7 ,holdover personal service arrangement ,in the case of a holdover personal service arrangement1 which immediately follows an arrangement described in subparagraph 7,a7 that expired after a term of at least one year1 remuneration from an entity pursuant to such holdover personal service arrangement1 if-- 7i7 the personal service arrangement hmet the conditions of subparagraph 7,a7 when the arrangement expired2 7ii7 the holdover personal service arrangement is on the same terms and conditions as the immediately preceding arrangement2 and 7iii7 the holdover arrangement continues to satisfy the conditions of subparagraph 7,a74 2 and 7#b7 in subsection 7h77#a71 as amended by section #c7;a7-- 7,a7 in the heading1 by inserting 2 holdover arrangement after remuneration2 and 7,b7 by adding at the end the following new subparagraph3 7,e7 ,holdover arrangement ,the term holdover arrangement means an arrangement1 with respect to an agreement 7including a lease or other arrangement7 that has expired but as of the date of such expiration had been in compliance with the applicable requirements of this section1 under which the parties to such expired agreement have1 since such date of expiration1 continued to perform under the terms and conditions of such expired agreement4 4