,,ii #aaith ,,congress #b;d ,session ,s4 #ecbf ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,august #f1 #bjbf,ms4 ,cortez ,masto 7for herself1 ,mr4 ,grassley1 ,mr4 ,wyden1 and ,mr4 ,crapo7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to strengthen program integrity oversight for the ,health ,care ,fraud and ,abuse ,control ,program1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,health ,care ,fraud ,prevention and ,enforcement ,act4 #b4 ,strengthening program integrity oversight for the ,health ,care ,fraud and ,abuse ,control ,program 7a7 ,additional funding 7#a7 ,departments of ,health and ,human ,services and ,justice ,section #ahag7k77#c77;,a77i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7k77#c77;,a77i77 is amended-- 7,a7 in subclause 7,,iii71 by striking and at the end2 7,b7 in subclause 7,,iv7-- 7i7 by inserting and before fiscal year #bjbg after after fiscal year #bjjf2 and 7ii7 by striking the period at the end and inserting a semicolon2 and 7,c7 by adding at the end the following new subclauses3 7,v7 for fiscal year #bjbg1 #dij1jjj1jjj2 7,,vi7 for fiscal year #bjbh1 #ebj1jjj1jjj2 7,,vii7 for fiscal year #bjbi1 #egj1jjj1jjj2 and 7,,viii7 for each fiscal year after fiscal year #bjbi1 the limit under this clause for the preceding fiscal year1 increased by the percentage increase in the consumer price index for all urban consumers 7all items2 ,united ,states city average7 over the previous year4 4 7#b7 ,office of the ,inspector ,general of the ,department of ,health and ,human ,services ,section #ahag7k77#c77;,a77ii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7k77#c77;,a77ii77 is amended-- 7,a7 in subclause 7,,viii71 by striking and at the end2 7,b7 in subclause 7,,ix7-- 7i7 by inserting and before fiscal year #bjbg after after fiscal year #bjjg2 and 7ii7 by striking the period at the end and inserting a semicolon2 and 7,c7 by adding at the end the following new subclauses3 7,x7 for fiscal year #bjbg1 #cbj1jjj1jjj2 7,,xi7 for fiscal year #bjbh1 #cdj1jjj1jjj2 7,,xii7 for fiscal year #bjbi1 #cgj1jjj1jjj2 and 7,,xiii7 for each fiscal year after fiscal year #bjbi1 not less than the amount required under this clause for the preceding fiscal year1 increased by the percentage increase in the consumer price index for all urban consumers 7all items2 ,united ,states city average7 over the previous year4 4 7#c7 ,federal ,bureau of ,investigation ,section #ahag7k77#c77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7k77#c77;,b77 is amended-- 7,a7 in clause 7vii71 by striking and at the end2 7,b7 in clause 7viii7-- 7i7 by inserting and before fiscal year #bjbg after after fiscal year #bjjf2 and 7ii7 by striking the period at the end and inserting a semicolon2 and 7,c7 by adding at the end the following new clauses3 7ix7 for fiscal year #bjbg1 #bcj1jjj1jjj2 7x7 for fiscal year #bjbh1 #bej1jjj1jjj2 7xi7 for fiscal year #bjbi1 #bgj1jjj1jjj2 and 7xii7 for each fiscal year after fiscal year #bjbi1 the amount to be appropriated under this subparagraph for the preceding fiscal year1 increased by the percentage increase in the consumer price index for all urban consumers 7all items2 ,united ,states city average7 over the previous year4 4 7#d7 ,medicare ,integrity ,program ,section #ahag7k77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7k77#d77 is amended-- 7,a7 in subparagraph 7,b7-- 7i7 in clause 7vii71 by inserting and before fiscal year #bjbg after after fiscal year #bjjb2 and 7ii7 by adding at the end the following new clauses3 7viii7 ,for fiscal year #bjbg1 #a1bhj1jjj1jjj4 7ix7 ,for fiscal year #bjbh1 #a1chj1jjj1jjj4 7x7 ,for fiscal year #bjbi1 #a1dhj1jjj1jjj4 7xi7 ,for each fiscal year after fiscal year #bjbi1 the amount appropriated under this subparagraph for the preceding fiscal year1 as increased pursuant to subparagraph 7,c77ii74 2 and 7,b7 in subparagraph 7,c77ii71 by striking ,for each fiscal year after #bjaj and inserting ,for each of fiscal years #bjaa through #bjbf1 and for each fiscal year after fiscal year #bjbi4 7#e7 ,medicare-,medicaid data match program ,section #ahag7k77#d77;,d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7k77#d77;,d77 is amended-- 7,a7 in clause 7v71 by inserting through fiscal year #bjbf after and each fiscal year thereafter2 and 7,b7 by adding at the end the following new clauses3 7vi7 #aaj1jjj1jjj for fiscal year #bjbg4 7vii7 #abj1jjj1jjj for fiscal year #bjbh4 7viii7 #acj1jjj1jjj for fiscal year #bjbi4 7ix7 ,for each fiscal year after fiscal year #bjbh1 the amount appropriated under this subparagraph for the preceding fiscal year1 as increased pursuant to subparagraph 7,c77ii74 4 7b7 ,expansion of investigative authority of the office of the inspector general of the department of health and human services ,section #ahag7k77#c77;,a77ii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7k77#c77;,a77ii77 is amended-- 7#a7 in the heading1 by striking ,medicare and medicaid activities and inserting ,office of the inspector general of the department of health and human services2 and 7#b7 in the matter preceding subclause 7,i71 by striking title ,,xix and inserting title ,,xix and any program established under title ,i 7or under the amendments made by such title7 of the ,patient ,protection and ,affordable ,care ,act 7,public ,law #aaa-adh7 that is administered by the ,secretary4 7c7 ,clarification concerning the definition of health plan ,section #aabh;,c of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;c7 is amended-- 7#a7 in subsection 7a77#a77;,b71 by inserting public and private before delivery2 and 7#b7 in subsection 7c71 in the matter preceding paragraph 7#a71 by inserting public or private before plan or program4 7d7 ,clarification of authority for the activities of the departments of justice and health and human services ,section #ahag7k77#c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7k77#c77 is amended by adding at the end the following new subparagraph3 7,d7 ,rule of construction4--,nothing in this paragraph shall be construed to limit the authority of the ,secretary1 the ,attorney ,general1 or the ,inspector ,general of the ,department of ,health and ,human ,services to use funds made available under this paragraph to-- 7i7 detect or prosecute health care fraud and abuse2 and 7ii7 communicate with the public about health care fraud4 4 7e7 ,annual report to congress ,section #ahag7k77#e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7k77#e77 is amended-- 7#a7 by redesignating subparagraphs 7,a7 and 7,b7 as clauses 7i7 and 7ii71 respectively1 and indenting appropriately2 7#b7 by striking report4--,not later than ,january #a and inserting 8report4-- 7,a7 ,in general ,not later than ,april #a 2 and 7#c7 by adding at the end the following new subparagraph3 7,b7 ,required notice of delay 7i7 ,in general ,if the annual report required under subparagraph 7,a7 is not submitted to ,congress by ,april #a of the year1 the ,secretary and ,attorney ,general shall jointly provide notice to the appropriate committees of ,congress beginning not later than such ,april #a1 and annually thereafter until such report is submitted to ,congress1 stating the reason for the delay4 7ii7 ,applicable committees of ,congress defined ,for purposes of this subparagraph1 the term appropriate committees of ,congress means the ,committees on ,finance and the ,budget of the ,senate and the ,committees on ,ways and ,means1 the ,budget1 and ,energy and ,commerce of the ,house of ,representatives4 4 7f7 ,process for determining funding allocation for departments of justice and health and human services ,section #ahag7k77#c77;,a77i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7k77#c77;,a77i77 is amended1 in the matter preceding subclause 7,i71 by striking certify and inserting agree4 7g7 ,inclusion of children's health insurance program in medicare-,medicaid data match program ,section #ahic7;g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;ddd7g77 is amended-- 7#a7 in paragraph 7#a77;,a7-- 7,a7 in the matter preceding clause 7i71 by striking under title ,,xix for the purpose of and inserting under title ,,xix1 and beginning with #bjbg1 with respect to the ,state ,children's ,health ,insurance ,program under title ,,xxi1 for the purpose of2 7,b7 in clause 7i71 by striking under this title and the ,medicaid program established under title ,,xix and inserting under this title1 the ,medicaid program established under title ,,xix1 and the ,state ,children's ,health ,insurance ,program established under title ,,xxi2 7,c7 in clause 7ii71 by inserting and the ,state ,children's ,health ,insurance ,program under title ,,xxi after under title ,,xix2 and 7,d7 in clause 7iii71 by striking both2 and 7#b7 in paragraph 7#b71 by striking titles ,,xi and ,,xix and inserting titles ,,xi1 ,,xix1 and ,,xxi4 #c4 ,,gao study and report on performance and effectiveness of ,health ,care ,fraud and ,abuse ,control ,program 7a7 ,study ,the ,comptroller ,general of the ,united ,states 7in this section referred to as the ,comptroller ,general7 shall conduct a study regarding the performance and effectiveness of the ,health ,care ,fraud and ,abuse ,control ,program4 ,to the extent feasible and data are available1 the study shall include the following3 7#a7 ,an analysis of how the ,department of ,health and ,human ,services and the ,department of ,justice have used their appropriations to achieve the goals of the ,health ,care ,fraud and ,abuse ,control ,program under section #aabh;,c of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;c74 7#b7 ,an analysis of performance assessments and other metrics the ,department of ,health and ,human ,services and the ,department of ,justice use to determine the performance and effectiveness of the ,health ,care ,fraud and ,abuse ,control ,program4 7#c7 ,a description of how the ,department of ,health and ,human ,services and the ,department of ,justice obligated funds for the ,health ,care ,fraud and ,abuse ,control ,program4 7#d7 ,an analysis of how the ,department of ,health and ,human ,services and the ,department of ,justice assess ,health ,care ,fraud and ,abuse ,control activities and whether key program outputs have changed over time since the most recent ,government ,accountability ,office report under section #ahag7k77#f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7k77#f774 7#e7 ,an analysis of evidence available regarding the effectiveness of the ,health ,care ,fraud and ,abuse ,control ,program in reducing health care fraud and abuse4 7#f7 ,an analysis of the timeliness of the annual ,health ,care ,fraud and ,abuse ,control report under section #ahag7k77#e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7k77#e77 and how the ,department of ,health and ,human ,services and the ,department of ,justice could improve the timeliness of such report4 7b7 ,report ,not later than #af months after the date of enactment of this ,act1 the ,comptroller ,general shall report to ,congress the results of the study conducted under subsection 7a71 together with recommendations for such legislation and administrative action as the ,comptroller ,general determines appropriate4