P.L. 104–191, Approved August 21, 1996 (110 Stat. 1998)

Health Insurance Portability and Accountability Act of 1996

*    *    *    *    *    *    *

SEC. 203. [42 U.S.C. 1395b-5] BENEFICIARY INCENTIVE PROGRAMS.

*    *    *    *    *    *    *

(b) Program To Collect Information on Fraud and Abuse.—

(1)  Establishment of program.—Not later than 3 months after the date of the enactment of this Act, the Secretary shall establish a program under which the Secretary shall encourage individuals to report to the Secretary information on individuals and entities who are engaging in or who have engaged in acts or omissions which constitute grounds for the imposition of a sanction under section 1128, 1128A, or 1128B of the Social Security Act, or who have otherwise engaged in fraud and abuse against the Medicare program under title XVIII of such act for which there is a sanction provided under law. The program shall discourage provision of, and not consider, information which is frivolous or otherwise not relevant or material to the imposition of such a sanction.

(2)  Payment of portion of amounts collected.—If an individual reports information to the Secretary under the program established under paragraph (1) which serves as the basis for the collection by the Secretary or the Attorney General of any amount of at least $100 (other than any amount paid as a penalty under section 1128B of the Social Security Act), the Secretary may pay a portion of the amount collected to the individual (under procedures similar to those applicable under section 7623 of the Internal Revenue Code of 1986 to payments to individuals providing information on violations of such Code).

(c) Program To Collect Information on Program Efficiency.—

(1)  Establishment of program.—Not later than 3 months after the date of the enactment of this Act, the Secretary shall establish a program under which the Secretary shall encourage individuals to submit to the Secretary suggestions on methods to improve the efficiency of the Medicare program.

(2)  Payment of portion of program savings.—If an individual submits a suggestion to the Secretary under the program established under paragraph (1) which is adopted by the Secretary and which results in savings to the program, the Secretary may make a payment to the individual of such amount as the Secretary considers appropriate.

*    *    *    *    *    *    *

SEC. 242. HEALTH CARE FRAUD.

*    *    *    *    *    *    *

(b) [42 U.S.C. 1395i note]  Criminal Fines Deposited in Federal Hospital Insurance Trust Fund.—The Secretary of the Treasury shall deposit into the Federal Hospital Insurance Trust Fund pursuant to section 1817(k)(2)(C) of the Social Security Act (42 U.S.C. 1395i) an amount equal to the criminal fines imposed under section 1347 of title 18, United States Code (relating to health care fraud).

*    *    *    *    *    *    *

SEC. 249. FORFEITURES FOR FEDERAL HEALTH CARE OFFENSES.

*    *    *    *    *    *    *

(c) [42 U.S.C. 1395i note] Property Forfeited Deposited in Federal Hospital Insurance Trust Fund.—

(1)  In general.—After the payment of the costs of asset forfeiture has been made and after all restoration payments (if any) have been made, and notwithstanding any other provision of law, the Secretary of the Treasury shall deposit into the Federal Hospital Insurance Trust Fund pursuant to section 1817(k)(2)(C) of the Social Security Act, as added by section 301(b), an amount equal to the net amount realized from the forfeiture of property by reason of a Federal health care offense pursuant to section 982(a)(6) of title 18, United States Code.

(2)  Costs of asset forfeiture.—For purposes of paragraph (1), the term “payment of the costs of asset forfeiture” means—

(A)  the payment, at the discretion of the Attorney General, of any expenses necessary to seize, detain, inventory, safeguard, maintain, advertise, sell, or dispose of property under seizure, detention, or forfeited, or of any other necessary expenses incident to the seizure, detention, forfeiture, or disposal of such property, including payment for—

(i)  contract services;

(ii)  the employment of outside contractors to operate and manage properties or provide other specialized services necessary to dispose of such properties in an effort to maximize the return from such properties; and

(iii)  reimbursement of any Federal, State, or local agency for any expenditures made to perform the functions described in this subparagraph;

(B)  at the discretion of the Attorney General, the payment of awards for information or assistance leading to a civil or criminal forfeiture involving any Federal agency participating in the Health Care Fraud and Abuse Control Account;

(C)  the compromise and payment of valid liens and mortgages against property that has been forfeited, subject to the discretion of the Attorney General to determine the validity of any such lien or mortgage and the amount of payment to be made, and the employment of attorneys and other personnel skilled in State real estate law as necessary;

(D)  payment authorized in connection with remission or mitigation procedures relating to property forfeited; and

(E)  the payment of State and local property taxes on forfeited real property that accrued between the date of the violation giving rise to the forfeiture and the date of the forfeiture order.

(3)  Restoration payment.—Notwithstanding any other provision of law, if the Federal health care offense referred to in paragraph (1) resulted in a loss to an employee welfare benefit plan within the meaning of section 3(1) of the Employee Retirement Income Security Act of 1974, the Secretary of the Treasury shall transfer to such employee welfare benefit plan, from the amount realized from the forfeiture of property referred to in paragraph (1), an amount equal to such loss. For purposes of paragraph (1), the term “restoration payment” means the amount transferred to an employee welfare benefit plan pursuant to this paragraph.

*    *    *    *    *    *    *

Subtitle F - Administrative Simplification

SEC. 261.  PURPOSE.

(a) [42 U.S.C. 1320d note]  It is the purpose of this subtitle to improve the Medicare program under title XVIII of the Social Security Act , the medicaid program under title XIX of such Act, and the efficiency and effectiveness of the health care system, by encouraging the development of a health information system through the establishment of uniform standards and requirements for the and to reduce the clerical burden on the patients, health care providers, and health plans.

*    *    *    *    *    *    *

SEC. 264. [42 U.S.C. 1320d-2 note] RECOMMENDATIONS WITH RESPECT TO PRIVACY OF CERTAIN HEALTH INFORMATION.

*    *    *    *    *    *    *

(b)  Subjects for Recommendations.—The recommendations under subsection (a) shall address at least the following:

(1)  The rights that an individual who is a subject of individually identifiable health information should have.

(2)  The procedures that should be established for the exercise of such rights.

(3)  The uses and disclosures of such information that should be authorized or required.

(c) Regulations.—

(1)  In general.—If legislation governing standards with respect to the privacy of individually identifiable health information transmitted in connection with the transactions described in section 1173(a) of the Social Security Act (as added by section 262) is not enacted by the date that is 36 months after the date of the enactment of this Act, the Secretary of Health and Human Services shall promulgate final regulations containing such standards not later than the date that is 42 months after the date of the enactment of this Act. Such regulations shall address at least the subjects described in subsection (b).

(2)  Preemption.—A regulation promulgated under paragraph (1) shall not supercede a contrary provision of State law, if the provision of State law imposes requirements, standards, or implementation specifications that are more stringent than the requirements, standards, or implementation specifications imposed under the regulation.

*    *    *    *    *    *    *

[Internal References.—SSAct §§1135(b)(7), 1178(a), 1180(b)(3), 1804(c)(3), 1817(k), 1893(d) and 2012(a) cite, and Titles XVIII and XIX have footnotes to, the Health Insurance Portability and Accountability Act of 1996.]