Summary: Medicaid Fraud Reduction Act of 2008 - Amends title XIX (Medicaid) of the Social Security Act (SSA), for purposes of determining or redetermining an individual's Medicaid eligibility, to direct each state to implement an asset verification program requiring Medicaid applicants or recipients to authorize the state to: (1) obtain records from a financial institution; and (2) use them to verify the individual's financial resources.Directs the Secretary of Health and Human Services to provide payments to eligible states to establish and carry out practices to reduce fraud under the state Medicaid program.Requires the Secretary to report to Congress on the feasibility of, and potential program savings from, implementing an electronic system for verifying asset transfers, particularly of real property, by Medicaid applicants or recipients. Authorizes the Secretary to require states to implement such a system if feasible and cost-effective.Requires withholding of federal matching payments to states for: (1) failure to implement an asset verification program; and (2) any expenditures other than for compensation of a state employee or payment to a state entity (for instance, expenditures for consultants).Requires states to submit to the Secretary state plan amendments for creating Internet-based transparency programs to improve public disclosure of Medicaid payments information.Amends SSA title XI to permit limitations, restrictions, and suspensions of Medicaid eligibility in cases of Medicaid-related civil or criminal fraud or abuse.Provides for an extended period of one year to recover Medicaid overpayments resulting from fraud or abuse.

medicaid fraud reduction act amends title xix medicaid social security act ssa purposes determining redetermining individual medicaid eligibility direct state implement asset verification program requiring medicaid applicants recipients authorize state obtain records financial institution use verify individual financial resources directs secretary health_and_human_services provide payments eligible states establish carry practices reduce fraud state medicaid program requires secretary report congress feasibility potential program savings implementing electronic system verifying asset transfers particularly real property medicaid applicants recipients authorizes secretary require states implement system feasible cost effective requires withholding federal matching payments states failure implement asset verification program expenditures compensation state employee payment state entity instance expenditures states submit secretary state plan amendments creating internet based transparency programs improve public disclosure medicaid payments information amends ssa title permit limitations restrictions suspensions medicaid eligibility cases medicaid related civil criminal fraud abuse provides extended period year recover medicaid overpayments resulting fraud abuse


Summary: National Vaccine Injury Compensation Program Improvement Act of 2008 - Amends the Public Health Service Act to revise provisions of the National Vaccine Injury Compensation Program.Specifies how loss of earning is to be calculated for vaccine-related injuries to individuals under the age of 18.Increases the award for vaccine-related deaths.Allows compensation under the Program for expenses for family counseling and for establishing and maintaining a guardianship, conservatorship, or trust for an individual with a vaccine-related injury.Allows a special master to make an interim award of attorneys' fees and costs under certain circumstances. Allows such award to be payable directly to the petitioner's attorney.Extends the statute of limitation for vaccine-related injury or death to six years after the date of injury or onset of symptoms.Specifies who is to be a member of the Advisory Commission on Childhood Vaccines. Provides that the Commission shall meet at the call of the Chair (currently, the Commission must meet not less than four times a year).Amends the Internal Revenue Code to increase the amount of expenses for administering the Program that are allowed to be paid from the Vaccine Injury Compensation Trust Fund. Allows the payment from the Trust Fund of administrative and personnel expenses that the Bureau of Public Debt incurs for financial services for the Trust Fund.Requires the Secretary of Health and Human Services to include a public service announcement in efforts to inform the public about the Program.

amends public_health_service_act revise provisions specifies loss earning calculated vaccine related injuries individuals age award vaccine related deaths allows compensation program expenses family counseling establishing maintaining guardianship conservatorship trust individual vaccine related injury allows special master interim award attorneys fees costs certain circumstances allows award payable directly petitioner attorney extends statute limitation vaccine related injury death years date injury onset symptoms specifies member provides commission shall meet chair currently commission meet times internal revenue code increase expenses administering program allowed paid allows payment trust_fund administrative personnel expenses incurs financial services trust_fund requires secretary health_and_human_services include public service announcement efforts inform public program


Summary: Medicaid Fraud Recovery Act of 2008 - Amends title XIX (Medicaid) of the Social Security Act to provide for: (1) use of local Medicaid fraud investigative units; and (2) enhanced Medicaid funding for anti-fraud activities by such local or state Medicaid fraud control units.

medicaid fraud recovery act amends title xix medicaid social security act provide use local medicaid fraud investigative units enhanced medicaid funding anti fraud activities local state medicaid fraud control units


Summary: Medicare Fraud Prevention Act of 2008 - Amends title XI of the Social Security Act (SSA) to increase civil money penalties, criminal fines, and prison sentences for fraud and abuse under the SSA title XVIII (Medicare) program. Amends SSA title XVIII to increase the amount of the surety bond required for suppliers of durable medical equipment (DME).

medicare fraud prevention act amends title social security act ssa increase civil money penalties criminal fines prison sentences fraud abuse ssa title xviii medicare program amends ssa title xviii increase surety bond required suppliers durable medical equipment dme


Summary: Seniors and Taxpayers Obligation Protection Act of 2008 - Directs the Secretary of Health and Human Services to establish and implement procedures to change the Medicare beneficiary identifier used to identify individuals entitled to benefits under part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act (SSA), or enrolled under part B (Supplementary Medical Insurance), so that such an individual's Social Security number is not used. Amends SSA title XVIII to direct the Secretary to establish and implement a system to verify on a monthly basis that the claims for reimbursement under Medicare part B for physicians' services furnished in high risk areas are: (1) for physicians' services actually furnished by the physician (or the physician's group practice); and (2) otherwise accurate. Requires the Secretary to establish a system to identify the 50 counties most vulnerable (high risk areas) to Medicare fraud. Directs the Secretary to study and report to Congress on the use of technology to provide real-time data analysis of Medicare reimbursement claims to identify and investigate unusual billing or order practices under the Medicare program that could indicate fraud or abuse. Requires the Secretary to establish procedures to require carriers, before paying a claim for reimbursement for durable medical equipment (DME), prosthetics, orthotics, and supplies (DMEPOS) to confirm with the National Supplier Clearinghouse: (1) that the supplier's Medicare identification number is active; and (2) that the item or service for which the reimbursement claim is submitted was properly identified on the CMS-855S Medicare enrollment application. Directs the Secretary to promulgate regulations for a unique identifier (serial number) tracking system for payment for DME. Expresses the sense of the Senate that the Secretary must put in place a surety bond requirement for DME suppliers within six months of the date of enactment of this Act in order to maintain Medicare program integrity.

seniors taxpayers obligation protection act directs secretary health_and_human_services establish implement procedures change medicare beneficiary identifier identify individuals entitled benefits title xviii medicare social security act ssa enrolled individual social_security number amends ssa title xviii direct secretary establish implement system verify monthly basis claims reimbursement medicare physicians services furnished high risk areas physicians services actually furnished physician physician group practice accurate requires secretary establish system identify counties vulnerable high risk areas medicare fraud directs secretary study report congress use technology provide real time data analysis medicare reimbursement claims identify investigate unusual billing order practices medicare program indicate fraud abuse requires secretary establish procedures require carriers paying claim reimbursement durable medical equipment dme prosthetics orthotics supplies dmepos confirm supplier medicare identification number active item service reimbursement claim submitted properly identified medicare enrollment application directs secretary promulgate regulations unique identifier serial number tracking system payment dme expresses sense senate secretary place surety bond requirement dme suppliers months date enactment act order maintain medicare program integrity


Summary: Medicare Fraud Prevention and Enforcement Act of 2009 - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to conduct an additional site inspection for each applicable items or services provider that applies for a provider number. Sets forth rules for the Secretary to conduct a background check on any individual or entity that applies for a Medicare provider number. Directs the Secretary to establish procedures for the registration of all applicant billing agencies and individuals. Requires the Secretary to assign a unique identification number to each registered agency and individual, which must appear on every claim for Medicare reimbursement. Amends SSA title XI to allow the Secretary to exclude from participation in any federal health care program any billing agency or individual that knowingly submitted or caused to be submitted a claim for Medicare reimbursement that it knows or should know is false or fraudulent. Requires that the information in the health integrity protection database (HIPDB) to be available to certain health care providers, suppliers, or practitioners as well as utilization and quality control peer review organizations and accreditation entities. Amends SSA title XVIII to require Medicare administrative contracts to require contractor reimbursements to the Secretary for amounts paid to excluded providers. Revises criteria for community mental health centers. Amends SSA titles XI and XVIII to deny a discharge in bankruptcy to civil monetary penalties for fraudulent activities by a health care provider or supplier, overpayments to service providers under Medicare part A and of benefits under Medicare part B (Supplementary Medical Insurance), and past-due obligations arising from breach of a scholarship or loan contract. Amends SSA title XI to prescribe a criminal penalty for illegal distribution of a Medicare or Medicaid beneficiary identification or provider number with intent to defraud. Amends the federal criminal code to: (1) prescribe criminal penalties for knowing, unauthorized use of information in the HIPDB; and (2) provide for the treatment of certain acts involving federal health care programs federal health care offenses. Authorizes any criminal investigator of the Office of Inspector General of HHS to: (1) obtain and execute any warrant or other process issued under federal authority; and (2) make warrantless arrests in specified circumstances. Requires all claims forms developed or used by the Secretary for Medicare reimbursement to accommodate the use of universal product numbers (UPNs, or bar codes) for a UPN-covered item, and all claims for such an item to contain the UPN.

amends title xviii medicare social security act direct secretary health_and_human_services hhs conduct additional site inspection applicable items services provider applies provider number sets forth rules secretary conduct background check individual entity applies medicare provider number directs secretary establish procedures registration applicant billing agencies individuals requires secretary assign unique identification number registered agency individual appear claim medicare reimbursement amends ssa title allow secretary exclude participation federal health care program billing agency individual knowingly submitted caused submitted claim medicare reimbursement knows know false fraudulent requires information health integrity protection database available certain health care providers suppliers practitioners utilization quality control peer review organizations accreditation entities amends ssa title xviii require medicare administrative contracts require contractor reimbursements secretary amounts paid excluded providers revises criteria community mental health centers amends ssa titles xviii deny discharge bankruptcy civil monetary penalties fraudulent activities health care provider supplier overpayments service providers medicare benefits medicare supplementary_medical_insurance past obligations arising breach scholarship loan contract amends ssa title prescribe criminal penalty illegal distribution medicare medicaid beneficiary identification provider number intent defraud amends federal criminal code prescribe criminal penalties knowing unauthorized use information provide treatment certain acts involving federal health care programs federal health care offenses authorizes criminal investigator office_of_inspector_general hhs obtain execute warrant process issued federal authority warrantless arrests specified circumstances requires claims forms developed secretary medicare reimbursement accommodate use universal product numbers bar codes covered item claims item contain


Summary: Medicare Fraud Prevention Act of 2009 - Amends title XI of the Social Security Act (SSA) to increase civil money penalties, criminal fines, and prison sentences for fraud and abuse under the SSA title XVIII (Medicare) program. Amends SSA title XVIII to increase the amount of the surety bond required for suppliers of durable medical equipment (DME).


Summary: Promoting Health Information Technology Act of 2009 - Establishes within the Department of Health and Human Services (HHS) an Office of the National Coordinator for Health Information Technology. Establishes the Health Information Technology Resource Center to provide assistance for the adoption and use of interoperable health information technology. Amends title XI (General Provisions, Peer Review, and Administrative Simplification) of the Social Security Act to require the Secretary of Health and Human Services to provide for an expedited upgrade program to develop and approve additions and modifications to adopted standards for the electronic exchange of health information. Sets forth the process for such additions and modifications. Prohibits federal funds from being used for the purchase of any health information technology that has not been certified in compliance with such standards. Requires federal agencies to comply with standards.Requires the Secretary to study current federal security and confidentiality standards. Amends the Internal Revenue Code to increase the limit on the amount a taxpayer may elect to expense for health care information technology as a depreciable asset. Requires the Secretary to encourage and facilitate the adoption of state reciprocity agreements for practitioner licensure in order to expedite the provision across state lines of telehealth services. Provides for studies related to telehealth services, including on expanding the list of Medicare telehealth originating sites, to include mental health facilities. Requires the Centers of Medicare & Medicaid Services to make federally qualified health centers eligible to participate in demonstration projects related to health records and heath information technology. Requires the Secretary to establish an interest-free loan program for hospitals to purchase and implement certified health information technology products.

establishes department_of_health_and_human_services hhs establishes provide assistance adoption use interoperable health information technology amends title general_provisions peer_review social security act require secretary health_and_human_services provide expedited upgrade program develop approve additions modifications adopted standards electronic exchange health information sets forth process additions modifications prohibits federal funds purchase health information technology certified compliance standards requires federal agencies comply standards requires secretary study current federal security confidentiality standards amends internal revenue code increase limit taxpayer elect expense health care information technology depreciable asset requires secretary encourage facilitate adoption state reciprocity agreements practitioner licensure order expedite provision state lines telehealth services provides studies related telehealth services including expanding list medicare telehealth originating sites include mental health facilities requires centers federally qualified health centers eligible participate demonstration projects related health records heath information technology requires secretary establish interest free loan program hospitals purchase implement certified health information technology products


Summary: Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2009 - Sets conditions for lawsuits arising from health care liability claims regarding health care goods or services or any medical product affecting interstate commerce. Sets a statute of limitations of three years after the date of manifestation of injury or one year after the claimant discovers the injury, with certain exceptions. Provides that nothing in this Act limits recovery of the full amount of available economic damages. Limits noneconomic damages to $250,000. Makes each party liable only for the amount of damages directly proportional to such party's percentage of responsibility. Allows the court to restrict the payment of attorney contingency fees. Limits the fees to a decreasing percentage based on the increasing value of the amount awarded. Allows the introduction of collateral source benefits and the amount paid to secure such benefits as evidence. Prohibits a provider of such benefits from recovering any amount from an award in a health care lawsuit involving injury or wrongful death. Authorizes the award of punitive damages only where: (1) it is proven by clear and convincing evidence that a person acted with malicious intent to injure the claimant or deliberately failed to avoid unnecessary injury the claimant was substantially certain to suffer; and (2) compensatory damages are awarded. Limits punitive damages to the greater of two times the amount of economic damages or $250,000. Denies punitive damages in the case of products approved, cleared, or licensed by the Food and Drug Administration (FDA), or otherwise considered in compliance with FDA standards. Provides for periodic payments of future damages.

help efficient accessible low cost timely healthcare health act sets conditions lawsuits arising health care liability claims health care goods services medical product affecting interstate commerce sets statute limitations years date manifestation injury year claimant discovers injury certain exceptions provides act limits recovery available economic damages limits noneconomic damages makes party liable damages directly proportional party percentage responsibility allows court restrict payment attorney contingency fees limits fees decreasing percentage based increasing value awarded allows introduction collateral source benefits paid secure benefits evidence prohibits provider benefits recovering award health care lawsuit involving injury wrongful death authorizes award punitive damages proven clear convincing evidence person acted malicious intent injure claimant deliberately failed avoid unnecessary injury claimant substantially certain suffer compensatory damages awarded limits punitive damages greater times economic damages denies punitive damages case products approved cleared licensed food_and_drug_administration fda considered compliance fda standards provides periodic payments future damages


Summary: Medical Justice Act of 2009 - Sets forth provisions regulating civil actions for an injury or death as the result of health care. Sets forth limits on: (1) the non-economic damages that an individual may recover from health care practitioners and health care institutions; and (2) the total damages that a person may recover from any single liable health care practitioner. Declares that an insurer of a health care practitioner or health care institution that rejects a reasonable settlement offer within policy limits is not, by reason of such rejection, liable for damages in excess of the liability of the insured. Sets forth requirements for qualified expert reports. Allows periodic or accrual payment for future damages. Prohibits a jury from awarding punitive or exemplary damages against a health care practitioner or health care institution unless the jury is unanimous. Makes each person liable only for a proportionate share of the total damages that directly corresponds to that person's responsibility. Makes a person liable for litigation costs incurred after rejection of a settlement offer if such person receives a judgment at trial that is significantly less favorable than the terms of the settlement offer. Sets forth a time frame within which claims related to any health care act or omission must be brought. Makes a health care practitioner or health care institution that provides emergency health care on a Good Samaritan basis immune from liability for damages caused by that care, except for willful or wanton negligence or more culpable misconduct.

medical justice act sets forth provisions regulating civil actions injury death result health care sets forth limits non economic damages individual recover health care practitioners health care institutions total damages person recover single liable health care practitioner declares insurer health care practitioner health care institution rejects reasonable settlement offer policy limits reason rejection liable damages excess liability insured sets forth requirements qualified expert reports allows periodic accrual payment future damages prohibits jury awarding punitive exemplary damages health care practitioner health care institution jury unanimous makes person liable proportionate share total damages directly corresponds person responsibility makes person liable litigation costs incurred rejection settlement offer person receives judgment trial significantly favorable terms settlement offer sets forth time frame claims related health care act omission brought makes health care practitioner health care institution provides emergency health care good samaritan basis immune liability damages caused care willful wanton negligence misconduct


Summary: Carmelo Rodriguez Military Medical Accountability Act of 2009 - Amends the Federal Tort Claims Act to allow claims for damages to be brought against the United States for personal injury or death of a member of the Armed Forces arising out of a negligent or wrongful act or omission in the performance of medical, dental, or related health care functions that is provided by persons acting within the scope of their office or employment by or at the direction of the government. Prohibits a claim under this Act from being reduced by the amount of any benefit received under Servicemembers Group Life Insurance. Makes this Act inapplicable to any claim arising out of the combatant activities of the Armed Forces during the time of armed conflict.

military medical accountability act amends federal tort claims act allow claims damages brought united_states personal injury death member armed_forces arising negligent wrongful act omission performance medical dental related health care functions provided persons acting scope office employment direction government prohibits claim act reduced benefit received makes act inapplicable claim arising combatant activities armed_forces time armed conflict


Summary: Quality Health Care Coalition Act of 2009 - Exempts health care professionals from federal antitrust laws in connection with negotiations with a health plan regarding contract terms under which the professionals provide health care items or services for which plan benefits are provided. Declares that this Act: (1) applies only to health care professionals excluded from the National Labor Relations Act; and (2) does not apply to such negotiations relating to Medicare or Medicaid programs, the State Children's Health Insurance Program (SCHIP), medical and dental care for members of the uniformed services, veterans' medical care, the federal employees health benefits program, or the Indian Health Care Improvement Act.

quality health care coalition act exempts health care professionals federal antitrust laws connection negotiations health plan contract terms professionals provide health care items services plan benefits provided declares act applies health care professionals excluded national_labor_relations_act apply negotiations relating medicare medicaid programs medical dental care members uniformed services veterans medical care federal employees health benefits program indian_health_care_improvement_act


Summary: Family Health Care Accessibility Act of 2010 - Amends the Public Health Service Act to deem a health professional volunteer providing primary health care to an individual at a community health center to be an employee of the Public Health Service for purposes of any civil action that may arise from providing services to patients. Sets forth conditions for such liability protection, including: (1) the service is provided to the individual at a community health center or through offsite programs or events carried out by such center; (2) the provider is sponsored by the community health center; (3) the health care practitioner does not receive any compensation for providing the service, except repayment for reasonable expenses; (4) before the service is provided, the health care practitioner or the center posts a clear and conspicuous notice at the site where the service is provided of the extent to which the legal liability of the health care practitioner is limited pursuant to this Act; (5) at the time the service is provided, the health care practitioner is licensed or certified in accordance with applicable law regarding the provision of the service; and (6) the Secretary of Health and Human Services (HHS) transfers funds to an account to cover costs for such coverage. Considers an entity as sponsoring the health care practitioner if: (1) the entity submits an application to the Secretary; and (2) the Secretary determines that the health care practitioner is deemed to be an employee of the Public Health Service. Requires the Attorney General to submit to Congress a report providing an estimate of the amount of claims (together with related fees and expenses of witnesses) that, by reason of the actions or omissions of health professional volunteers, will be paid pursuant to this Act during the calendar year that begins in the following fiscal year. Requires the Secretary to transfer such estimated amount from the claims fund to the appropriate accounts in the Treasury, subject to the extent of amounts in the fund. Makes this Act effective on October 1, 2011, except permits upon its enactment: (1) the Secretary to issue regulations for carrying out this Act and to accept and consider applications under this Act; and (2) the Attorney General to submit reports to Congress under this Act.

family health care accessibility act amends public_health_service_act deem health professional volunteer providing primary health care individual community health center employee public_health_service purposes civil action arise providing services patients sets forth conditions liability protection including service provided individual community health center offsite programs events carried center provider sponsored community health center health care practitioner receive compensation providing service repayment reasonable expenses service provided health care practitioner center posts clear conspicuous notice site service provided extent legal liability health care practitioner limited pursuant act time service provided health care practitioner licensed certified accordance applicable law provision service secretary health_and_human_services hhs transfers funds account cover costs coverage considers entity sponsoring health care practitioner entity submits application secretary secretary determines health care practitioner deemed employee public_health_service requires attorney general submit congress report providing estimate claims related fees expenses witnesses reason actions omissions health professional volunteers paid pursuant act calendar year begins following fiscal year requires secretary transfer estimated claims fund appropriate accounts treasury subject extent amounts fund makes act effective october permits enactment secretary issue regulations carrying act accept consider applications act attorney general submit reports congress act


Summary: Health Care Paperwork Reduction and Fraud Prevention Act of 2009 - Establishes the Commission on Health Care Billing Codes and Forms Simplification which shall make recommendations regarding: (1) standardizing and simplifying credentialing and billing forms for health care claims; (2) reducing and simplifying billing codes; (3) reforming the Medicare regulatory and appeals processes to ensure that the Secretary of Health and Human Services provides appropriate guidance to providers for submitting Medicare claims and does not target inadvertent billing errors; and (4) updating electronic forms of the Centers for Medicare & Medicaid Services to ensure simplicity and privacy. Directs the Secretary of Health and Human Services to establish a process under which a physician may request from a carrier written assistance in addressing questionable codes and procedures under the Medicare program. Requires the Administrator of the Centers for Medicare & Medicaid Services to restore the toll-free telephone hotline so that physicians may call for information and questions about the Medicare program. Prohibits the Administrator from implementing any new evaluation and management (E&M) guidelines under the Medicare program unless the Administrator: (1) has provided for an assessment of the proposed guidelines by physicians; (2) has established a plan that contains specific goals, including a schedule for improving participation of physicians in such assessment; (3) has carried out a minimum of four pilot projects in at least four different regions to test E&M guidelines; and (4) finds that specified objectives will be met in the implementation of such guidelines. Sets forth provisions concerning: (1) physician participation and pilot program testing requirements and objectives for new E&M guidelines under Medicare; and (2) notice, administrative, and penalty requirements with respect to Medicare overpayments.

fraud prevention act establishes commission forms simplification shall recommendations simplifying credentialing billing forms health care claims reducing simplifying billing codes reforming medicare regulatory appeals processes ensure secretary health_and_human_services provides appropriate guidance providers submitting medicare claims target inadvertent billing errors updating electronic forms centers ensure privacy directs secretary health_and_human_services establish process physician request carrier written assistance addressing codes procedures medicare program requires administrator centers restore toll free telephone hotline physicians information questions medicare program prohibits administrator implementing new evaluation management guidelines medicare program administrator provided assessment proposed guidelines physicians established plan contains specific goals including schedule improving participation physicians assessment carried minimum pilot projects different regions test guidelines finds specified objectives met implementation guidelines sets forth provisions concerning physician participation pilot program testing requirements objectives new guidelines medicare notice administrative penalty requirements respect medicare overpayments


Summary: Integrity in Medicare Advanced Diagnostic Imaging Act of 2009 - Amends title XVIII (Medicare) of the Social Security Act to exclude certain advanced diagnostic imaging services from the in-office ancillary services exception to the prohibition on physician self-referral. (Thus prohibits a physician [or an immediate family member] who has an ownership or investment relationship or compensation arrangement with an entity from referring a patient to the entity for certain advanced diagnostic imaging services for which a Medicare payment otherwise may be made.)

integrity medicare advanced diagnostic imaging act amends title xviii medicare social security act exclude certain advanced diagnostic imaging services office ancillary services exception prohibition physician self referral prohibits physician immediate family member ownership investment relationship compensation arrangement entity referring patient entity certain advanced diagnostic imaging services medicare payment


Summary: Medical Practice Protection Act of 2009 - Sets conditions for lawsuits arising from health care liability claims regarding health care goods or services or any medical product affecting interstate commerce. Sets a statute of limitations of three years after the date of manifestation of injury or one year after the claimant discovers the injury, with certain exceptions. Limits noneconomic damages to $250,000. Makes each party liable only for the amount of damages directly proportional to such party's percentage of responsibility. Allows the court to restrict the payment of attorney contingency fees. Limits the fees to a decreasing percentage based on the increasing value of the amount awarded. Allows the introduction of collateral source benefits and the amount paid to secure such benefits as evidence. Prohibits a provider of such benefits from recovering any amount from an award in a health care lawsuit involving injury or wrongful death. Authorizes the award of punitive damages only where: (1) it is proven by clear and convincing evidence that a person acted with malicious intent to injure the claimant or deliberately failed to avoid unnecessary injury the claimant was substantially certain to suffer; and (2) compensatory damages are awarded. Provides for periodic payments of future damages.

sets conditions lawsuits arising health care liability claims health care goods services medical product affecting interstate commerce sets statute limitations years date manifestation injury year claimant discovers injury certain exceptions limits noneconomic damages makes party liable damages directly proportional party percentage responsibility allows court restrict payment attorney contingency fees limits fees decreasing percentage based increasing value awarded allows introduction collateral source benefits paid secure benefits evidence prohibits provider benefits recovering award health care lawsuit involving injury wrongful death authorizes award punitive damages proven clear convincing evidence person acted malicious intent injure claimant deliberately failed avoid unnecessary injury claimant substantially certain suffer compensatory damages awarded provides periodic payments future damages


Summary: Health Care OverUse Reform Today Act (HealthCOURT Act) of 2009 - Directs the Secretary of Health and Human Services (HHS) to propose to Congress a formalized process for the development of performance-based quality measures that could be applied to physicians' services under title XVIII (Medicare) of the Social Security Act. Requires the proposal: (1) to be in concert and agreement with the Physician Consortium for Performance Improvement; and (2) utilize only measures agreed upon by each physician specialty organization. Directs the Secretary to: (1) provide for the selection and issuance of best practice guidelines for treatment of medical conditions; and (2) contract with a qualified physician consensus-building organization (such as the Physician Consortium for Performance Improvement), in concert and agreement with physician specialty organizations, to develop such guidelines. Prohibits the award of any noneconomic damages in any health care lawsuit with respect to treatment that is within an issued guideline. Prohibits the award of punitive damages against a health care practitioner in such a lawsuit based on a claim that medical treatment caused the claimant harm if the treatment: (1) was subject to quality review by a qualified physician consensus-building organization; (2) was approved in a guideline that underwent full review by such organization, public comment, the Secretary's approval, and dissemination; and (3) is generally recognized among qualified experts as safe, effective, and appropriate. Amends the Public Health Service Act to authorize the Secretary to award grants to states for the development, implementation, and evaluation of administrative health care tribunals for the resolution of disputes concerning injuries allegedly caused by health care providers. Expresses the sense of Congress that a health insurance issuer should be liable for damages for a harm caused when it makes a decision as to what care is medically necessary and appropriate.

today act act directs secretary health_and_human_services hhs propose congress process development performance based quality measures applied physicians services title xviii medicare social security act requires proposal concert agreement performance improvement utilize measures agreed physician specialty organization directs secretary provide selection issuance best practice guidelines treatment medical conditions contract qualified physician consensus building organization performance improvement concert agreement physician specialty organizations develop guidelines prohibits award noneconomic damages health care lawsuit respect treatment issued guideline prohibits award punitive damages health care practitioner lawsuit based claim medical treatment caused claimant harm treatment subject quality review qualified physician consensus building organization approved guideline review organization public comment secretary approval dissemination generally recognized qualified experts safe effective appropriate amends public_health_service_act authorize secretary award grants states development implementation evaluation administrative health care tribunals resolution disputes concerning injuries allegedly caused health care providers expresses sense congress health insurance issuer liable damages harm caused makes decision care medically necessary appropriate


Summary: Comprehensive Medical Malpractice Reform Act of 2009 - Limits the non-economic damages that an individual may recover from a health care provider for an injury or death as the result of health care malpractice to $250,000 as adjusted for inflation from 1975. Requires a medical malpractice action to be dismissed unless the signer of complaint certifies its validity. Directs the Secretary of Health and Human Services (HHS) to: (1) develop voluntary performance standards applicable to state medical boards; and (2) establish an interstate patient reporting and physician tracking database. Directs the Attorney General to make grants to states and health care entities to carry out mediation programs to resolve health care malpractice allegations without litigation. Amends the Public Health Service Act to provide for the voluntary disclosure of patient safety information to patient safety organizations. Makes such information privileged. Directs the Secretary to establish a database to receive relevant non-identifiable patient safety information. Limits the liability of a health care provider that provides information to a state medical board regarding the competence or professional conduct of a physician.

comprehensive medical malpractice reform act limits non economic damages individual recover health care provider injury death result health care malpractice adjusted inflation requires medical malpractice action dismissed complaint certifies validity directs secretary health_and_human_services hhs develop voluntary performance standards applicable state medical boards establish interstate patient reporting physician tracking database directs attorney general grants states health care entities carry mediation programs resolve health care malpractice allegations litigation amends public_health_service_act provide voluntary disclosure patient safety information patient safety organizations makes information privileged directs secretary establish database receive relevant non identifiable patient safety information limits liability health care provider provides information state medical board competence professional conduct physician


Summary: Authorizes the Secretary of Health and Human Services (HHS) to make grants to five states to establish pilot programs under which: (1) each medical malpractice case is heard in the first instance by a medical tribunal composed of a state trial court judge, a physician, and a lawyer; and (2) the tribunal shall hear all evidence that would be admissible in state court and determine whether it would be sufficient to support a finding for the plaintiff. Permits the plaintiff to pursue a case through the state's usual judicial process: (1) if the tribunal determines that the evidence would be sufficient; or (2) if the tribunal determines that the evidence would be insufficient, but only after filing with the clerk of the court a bond in an amount determined by the state trial court judge. Permits the Secretary to award a grant to only a state that: (1) has an average cost of medical malpractice insurance that exceeds the national average; and (2) has not placed a limit on noneconomic damages in medical malpractice cases or established a medical tribunal program similar to the one described in this Act. Directs the Secretary to collect from each state that receives grant funds, after the end of the third fiscal year, certain data regarding: (1) changes in the average cost of medical malpractice insurance, the number of physicians actively practicing medicine, the number of medical malpractice liability insurance carriers, the amounts paid by such carriers pursuant to settlements or judgments, and the percentage of medical malpractice cases settled prior to trial; and (2) the number of cases that were considered meritorious by the tribunal, and the number that were considered nonmeritorious, that were tried to a judgment and the number of such judgments that were for the plaintiff.

authorizes secretary health_and_human_services hhs grants states establish pilot programs medical malpractice case heard instance medical tribunal composed state trial court judge physician lawyer tribunal shall hear evidence admissible state court determine sufficient support finding plaintiff permits plaintiff pursue case state usual judicial process tribunal determines evidence sufficient tribunal determines evidence insufficient filing clerk court bond determined state trial court judge permits secretary award grant state average cost medical malpractice insurance exceeds national average placed limit noneconomic damages medical malpractice cases established medical tribunal program similar described act directs secretary collect state receives grant funds end fiscal year certain data changes average cost medical malpractice insurance number physicians actively practicing medicine number medical malpractice liability insurance carriers amounts paid carriers pursuant settlements judgments percentage medical malpractice cases settled prior trial number cases considered meritorious tribunal number considered tried judgment number judgments plaintiff


Summary: National Vaccine Injury Compensation Program Modernization Act of 2009 - Amends the Public Health Service Act to extend the limitation period for filing a petition to compensate a vaccine-related injury under the National Vaccine Injury Compensation Program.

amends public_health_service_act extend limitation period filing petition compensate vaccine related injury


Summary: Prevent Health Care Fraud Act of 2009 - Establishes in the Department of Health and Human Services (HHS) the Office of the Deputy Secretary for Health Care Fraud Prevention. Requires the Office to: (1) direct the implementation within HHS of health care fraud prevention and detection recommendations made by federal and private sector antifraud and oversight entities; (2) routinely consult with HHS's Office of the Inspector General, the Attorney General, and private sector health care antifraud entities to identify emerging fraud issues requiring immediate action; (3) provide for the design, development, and operation of a predictive model antifraud system to analyze health care claims data in real-time to identify high risk claims activity and develop a comprehensive antifraud database for federal health agency activities; (4) promulgate and enforce regulations relating to the reporting of data claims to such system by federal health agencies; (5) establish thresholds for fraudulent, wasteful, or abusive claims for excluding providers or suppliers from participation in federal health programs and for the referral of claims to law enforcement entities; and (6) share antifraud information and best practices. Sets forth requirements for the fraud prevention system, including that it shall: (1) allow viewing of all provider and patient activities across all federal health program payers; (2) provide for a centralized file for data from all government health insurance claims data sources; (3) provide real-time ability to identify high-risk behavior patterns across markets, geographies, and specialty group providers; (4) involve the implementation of a predictive modeling technology that is designed to prevent waste, fraud, and abuse; (5) systematically present scores, reason codes, and treatment actions for high-risk scored transactions; (6) monitor consumer transactions in real-time and monitor provider behavior at different stages within the transaction flow based upon provider, transaction, and consumer trends; and (7) not be designed to deny health care services or to negatively impact prompt-pay laws because assessments are late. Directs the Deputy Secretary to: (1) prohibit the payment of any health care claim identified as potentially fraudulent, wasteful, or abusive until the claim has been verified as valid; and (2) provide maximum protection of personal privacy consistent with carrying out the Office's responsibilities. Directs the Secretary to establish procedures for the implementation of fraud and abuse detection methods under all federal health programs.

prevent health care fraud act establishes department_of_health_and_human_services hhs office deputy secretary requires office direct implementation hhs health care fraud prevention detection recommendations federal private sector antifraud oversight entities routinely consult hhs office_of_the_inspector_general attorney general private sector health care antifraud entities identify emerging fraud issues requiring immediate action provide design development operation predictive model antifraud system analyze health care claims data real time identify high risk claims activity develop comprehensive antifraud database federal health agency activities promulgate enforce regulations relating reporting data claims system federal health agencies establish thresholds fraudulent wasteful abusive claims excluding providers suppliers participation federal health programs referral claims law enforcement entities share antifraud information best practices sets forth requirements fraud prevention system including shall allow viewing provider patient activities federal health program payers provide centralized file data government health insurance claims data sources provide real time ability identify high risk behavior patterns markets specialty group providers involve implementation predictive modeling technology designed prevent waste fraud abuse systematically present scores reason codes treatment actions high risk transactions monitor consumer transactions real time monitor provider behavior different stages transaction flow based provider transaction consumer trends designed deny health care services negatively impact prompt pay laws assessments late directs deputy secretary prohibit payment health care claim identified potentially fraudulent wasteful abusive claim verified valid provide maximum protection personal privacy consistent carrying office responsibilities directs secretary establish procedures implementation fraud abuse detection methods federal health programs


Summary: Medicare Fraud Enforcement and Prevention Act of 2010 - Amends title XI of the Social Security Act (SSA) to increase criminal penalties for both felony and misdemeanor fraud under SSA titles XVIII (Medicare) and XIX (Medicaid). Adds a new offense of distribution of two or more Medicare or Medicaid beneficiary identification numbers or billing privileges with the intent to defraud. Applies civil monetary penalties to: (1) conspiracy to make false statements or commit other specified offenses with respect to Medicare or Medicaid claims; and (2) knowing creation or use of false records or statements with respect to the transmission of money or property to a federal health care program. Extends the statute of limitations from six to 10 years after presentation of a claim. Amends SSA title XVIII (Medicare), as amended by the Patient Protection and Affordable Care Act (PPACA), to revise screening requirements. Amends SSA title XI, as amended by PPACA, to require the access to claims and payment data granted to Inspector General of the Department of Health and Human Services (HHS) and the Attorney General to include access to real time claims and payment data. Requires the HHS Inspector General to implement mechanisms for the sharing of information about suspected fraud relating to the federal health care programs under Medicare, Medicaid, and SSA title XXI (Children's Health Insurance Program) (CHIP) with other appropriate law enforcement officials. Directs the HHS Secretary to carry out a five-year pilot program that implements biometric technology to ensure that individuals entitled to benefits under Medicare part A or enrolled under Medicare part B are physically present at the time and place of receipt of certain items and services for which payment may be made. Requires the Comptroller General to study and report to Congress on Medicare administrative contractors, including Recovery Audit Contractors.

amends title social security act ssa increase criminal penalties felony misdemeanor fraud ssa titles xviii medicare xix medicaid adds new offense distribution medicare medicaid beneficiary identification numbers billing privileges intent defraud applies civil monetary penalties conspiracy false statements commit specified offenses respect medicare medicaid claims knowing creation use false records statements respect transmission money property federal health care program extends statute limitations years presentation claim amends ssa title xviii medicare amended patient_protection affordable care act ppaca revise screening requirements amends ssa title amended ppaca require access claims payment data granted inspector general department_of_health_and_human_services hhs attorney general include access real time claims payment data requires hhs inspector general implement mechanisms sharing information suspected fraud relating federal health care programs medicare medicaid ssa title chip appropriate law enforcement officials directs hhs secretary carry year pilot program implements biometric technology ensure individuals entitled benefits medicare enrolled medicare physically present time place receipt certain items services payment requires comptroller general study report congress medicare administrative contractors including


Summary: Amends the Patient Protection and Affordable Care Act (PPACA) to prohibit the development, recognition, or implementation of any guideline or other standard under any provision of PPACA from being construed to establish the standard of care or duty of care owed by health care providers to their patients in any medical malpractice action or claim. Declares that nothing in PPACA shall be construed to modify or impair state law governing legal standards or procedures used in medical malpractice cases, including the authority of a state to make or implement such law.

amends patient_protection affordable care act ppaca prohibit development recognition implementation guideline standard provision ppaca construed establish standard care duty care owed health care providers patients medical malpractice action claim declares ppaca shall construed modify impair state law governing legal standards procedures medical malpractice cases including authority state implement law


Summary: Amends the Patient Protection and Affordable Care Act (PPACA) to repeal: (1) the prohibition against Medicare participation by physician-owned hospitals that do not have a provider agreement by August 1, 2010, which nonetheless allows their Medicare participation under a rural provider and hospital exception to a specified ownership or investment prohibition if they meet certain requirements; and (2) the requirement that drug, device, biological and medical supply manufacturers report to the Secretary of Health and Human Services (HHS) any transfers of value made to a physician, physician medical practice, a physician group practice, and/or teaching hospital, as well as information on any physician ownership or investment interest in the manufacturer. Restores or revives related previous law amended or repealed by PPACA as if PPACA had not been enacted.

amends patient_protection affordable care act ppaca repeal prohibition medicare participation physician owned hospitals provider agreement august nonetheless allows medicare participation rural provider hospital exception specified ownership investment prohibition meet certain requirements requirement drug device biological medical supply manufacturers report secretary health_and_human_services hhs transfers value physician physician medical practice physician group practice teaching hospital information physician ownership investment interest manufacturer restores revives related previous law amended repealed ppaca ppaca enacted


Summary: Directs the Secretary of Health and Human Services (HHS) to develop and implement a fraud, waste, and abuse comprehensive prepayment review Prevention System for reviewing claims for reimbursement under title XVIII (Medicare) of the Social Security Act. Requires the Secretary to carry out the system acting through the Center for Program Integrity of the Centers for Medicare and Medicaid Services (CMS). Requires the Prevention System to cover all types of providers and suppliers under the Medicare program, but allows it to be limited to a subset of claim segments. Requires the Prevention System to: (1) be a high volume, rapid, near real-time information technology solution which includes data pooling and scoring capabilities to quickly and accurately capture and evaluate data; (2) identify high-risk Medicare claims by scoring all such claims in near real-time before payment is made; (3) involve a statistically sound, empirically derived predictive modeling technology; and (4) utilize a fraud management system that presents score, reason codes, and treatment actions for high-risk scored transactions, and a feedback loop to gain access to outcome information on adjudicated Medicare claims. Prohibits the Secretary from making a payment on a claim selected for review until it has been reviewed under the System.

directs secretary health_and_human_services hhs develop implement fraud waste abuse comprehensive prepayment review reviewing claims reimbursement title xviii medicare social security act requires secretary carry system acting medicare medicaid_services cms requires prevention system cover types providers suppliers medicare program allows limited subset claim segments requires prevention system high volume rapid near real time information technology solution includes data pooling scoring capabilities quickly accurately capture evaluate data identify high risk medicare claims scoring claims near real time payment involve statistically sound derived predictive modeling technology utilize fraud management system presents score reason codes treatment actions high risk transactions feedback loop gain access outcome information adjudicated medicare claims prohibits secretary making payment claim selected review reviewed system


Summary: Meaningful End to Defensive Medicine & Aimless Lawsuits (MedMal) Act of 2010 - Sets forth provisions regulating lawsuits for health care liability claims related to the provision of health care goods or services. Sets a statute of limitations of three years after the date of the manifestation of injury or one year after the claimant discovers the injury, with certain exceptions. Caps the amount of noneconomic damages at $350,000 if a claimant rejects a settlement that meets certain criteria. Prohibits a provider of collateral source benefits from recovering any amount from an award in a health care lawsuit involving injury or wrongful death. Makes a benevolent gesture or admission of fault that is made by a health care provider or employee to the claimant or the claimant's relative or representative inadmissible as evidence of an admission of liability or an admission against interest. Makes each party liable only for the amount of damages proportional to such party's percentage of responsibility. Authorizes the award of punitive damages only where: (1) it is otherwise permitted by applicable state or federal law; (2) it is proven by clear and convincing evidence that the defendant acted with malicious intent to injure the claimant or deliberately failed to avoid unnecessary injury the claimant was substantially certain to suffer; and (3) compensatory damages are awarded. Provides for periodic payment of future damages. Prohibits a health care provider from being named as a party to a product liability lawsuit for prescribing or dispensing a Food and Drug Administration (FDA)-approved medical product. Prescribes qualifications for expert witnesses.

meaningful end act sets forth provisions regulating lawsuits health care liability claims related provision health care goods services sets statute limitations years date manifestation injury year claimant discovers injury certain exceptions caps noneconomic damages claimant rejects settlement meets certain criteria prohibits provider collateral source benefits recovering award health care lawsuit involving injury wrongful death makes admission fault health care provider employee claimant claimant relative representative inadmissible evidence admission liability admission interest makes party liable damages proportional party percentage responsibility authorizes award punitive damages permitted applicable state federal law proven clear convincing evidence defendant acted malicious intent injure claimant deliberately failed avoid unnecessary injury claimant substantially certain suffer compensatory damages awarded provides periodic payment future damages prohibits health care provider named party product liability lawsuit prescribing dispensing food_and_drug_administration medical product prescribes qualifications expert witnesses


Summary: Fighting Fraud and Abuse to Save Taxpayers' Dollars Act or FAST Act - Directs the Secretary of Health and Human Services (HHS), in order to ensure that service providers and suppliers that have operated in one state but are excluded from participation in the Medicare program are unable to participate in other federal health care programs in another state, to provide for increased coordination among specified federal, state, and related agencies. Requires the Secretary to allow greater integration between Medicare databases so that: (1) Medicare administrative contractors, fiscal intermediaries, and carriers have immediate access to information identifying providers and suppliers excluded from participation in programs under titles XVIII (Medicare), XIX (Medicaid), or XXI (Children's Health Insurance Program) (CHIP) of the Social Security Act (SSA), as well as other federal health care programs; and (2) such information can be shared on a real-time basis across federal health care programs and agencies, and with state health agencies, state Medicaid and CHIP plans, and related contractors. Requires the Secretary to implement fully the waste, fraud, and abuse detection solution of the Centers for Medicare & Medicaid Services called the One PI project by January 1, 2013. Grants federal and state agencies real-time access to the National Practitioner Data Bank. Authorizes the Secretary to allow state Medicaid fraud control units and state and local law enforcement officials access to federal Medicare, Medicaid, and CHIP claims and payment data. Directs the Comptroller General to study and report to Congress on whether and, if so, to what degree, the Federation of State Medical Boards may be useful in further strengthening the integrity of processes for enrolling service providers and suppliers under federal health care programs. Amends the SSA, as amended by the Patient Protection and Affordable Care Act, to authorize information in the National Practitioner Data Bank to be made available on a real-time basis to specified federal, state, and private health care entities. Directs the Secretary to establish an appeals process under which service providers or suppliers may have their names removed from the National Practitioner Data Bank. Prohibits the Secretary from contracting with a Medicare administrative contractor unless the contractor agrees to reimburse the Secretary for any amounts paid for any non-emergency item or service furnished by or at the medical direction of an individual or entity excluded from Medicare participation. Denies discharge in bankruptcy proceedings of: (1) civil monetary penalties; (2) amounts due the Secretary for overpayment of service providers where a health care provider or a supplier engages in fraudulent activity; or (3) amounts due from breach of a scholarship or loan contract. Prohibits Medicaid or CHIP payments for items or services unless the claim contains a valid beneficiary identification number and a valid National Provider Identifier. Requires managed care entities and Medicaid managed care organizations to comply with certain screening, oversight, and reporting requirements. Subjects to specified criminal penalties the knowing, intentional, and fraudulent purchase, sale, or distribution of a Medicare, Medicaid, or CHIP beneficiary identification number or billing privileges. Directs the Secretary to establish a two-year pilot program under which Medicare claims for items covered by universal product numbers (UPNs) contain the UPN. Requires the Secretary to establish cost-effective procedures to ensure that a Social Security account number (or any derivative) is not displayed, coded, or embedded on an individual's Medicare card.

fighting fraud fast act directs secretary health_and_human_services hhs order ensure service providers suppliers operated state excluded participation medicare program unable participate federal health care programs state provide increased coordination specified federal state related agencies requires secretary allow greater integration medicare databases medicare administrative contractors fiscal intermediaries carriers immediate access information identifying providers suppliers excluded participation programs titles xviii medicare xix medicaid chip social security act ssa federal health care programs information shared real time basis federal health care programs agencies state health agencies state medicaid chip plans related contractors requires secretary implement fully waste fraud abuse detection solution called project january grants federal state agencies real time access national_practitioner_data_bank authorizes secretary allow state medicaid fraud control units state local law enforcement officials access federal medicare medicaid chip claims payment data directs comptroller general study report congress degree useful strengthening integrity processes enrolling service providers suppliers federal health care programs amends ssa amended patient_protection affordable care act authorize information national_practitioner_data_bank available real time basis specified federal state private health care entities directs secretary establish appeals process service providers suppliers names removed national_practitioner_data_bank prohibits secretary contracting medicare administrative contractor contractor agrees reimburse secretary amounts paid non emergency item service furnished medical direction individual entity excluded medicare participation denies discharge bankruptcy proceedings civil monetary penalties amounts secretary overpayment service providers health care provider supplier engages fraudulent activity amounts breach scholarship loan contract prohibits medicaid chip payments items services claim contains valid beneficiary identification number valid national provider identifier requires managed care entities medicaid managed care organizations comply certain screening oversight reporting requirements subjects specified criminal penalties knowing intentional fraudulent purchase sale distribution medicare medicaid chip beneficiary identification number billing privileges directs secretary establish year pilot program medicare claims items covered universal product numbers contain requires secretary establish cost effective procedures ensure social_security account number derivative displayed coded embedded individual medicare card


Summary: Medical Care Access Protection Act of 2009 or the MCAP Act - Sets forth provisions regulating lawsuits for health care liability claims related to the provision of health care services. Sets a statute of limitations of three years after the date of manifestation of injury or one year after the claimant discovers the injury, with certain exceptions. Requires a court to impose sanctions for the filing of frivolous lawsuits. Limits noneconomic damages to $250,000 from the provider or health care institution, but no more than $500,000 from multiple health care institutions. Makes each party liable only for the amount of damages directly proportional to such party's percentage of responsibility. Allows the court to restrict the payment of attorney contingency fees. Limits the fees to a decreasing percentage based on the increasing value of the amount awarded. Prescribes qualifications for expert witnesses. Requires the court to reduce damages received by the amount of collateral source benefits to which a claimant is entitled, unless the payor of such benefits has the right to reimbursement or subrogation under federal or state law. Authorizes the award of punitive damages only where: (1) it is proven by clear and convincing evidence that a person acted with malicious intent to injure the claimant or deliberately failed to avoid unnecessary injury the claimant was substantially certain to suffer; and (2) compensatory damages are awarded. Limits punitive damages to the greater of two times the amount of economic damages or $250,000. Prohibits a health care provider from being named as a party in a product liability or class action lawsuit for prescribing or dispensing a Food and Drug Administration (FDA)-approved prescription drug, biological product, or medical device for an approved indication. Provides for periodic payments of future damage awards.

act sets forth provisions regulating lawsuits health care liability claims related provision health care services sets statute limitations years date manifestation injury year claimant discovers injury certain exceptions requires court impose sanctions filing frivolous lawsuits limits noneconomic damages provider health care institution multiple health care institutions makes party liable damages directly proportional party percentage responsibility allows court restrict payment attorney contingency fees limits fees decreasing percentage based increasing value awarded prescribes qualifications expert witnesses requires court reduce damages received collateral source benefits claimant entitled payor benefits right reimbursement subrogation federal state law authorizes award punitive damages proven clear convincing evidence person acted malicious intent injure claimant deliberately failed avoid unnecessary injury claimant substantially certain suffer compensatory damages awarded limits punitive damages greater times economic damages prohibits health care provider named party product liability class action lawsuit prescribing dispensing food_and_drug_administration prescription drug biological product medical device approved indication provides periodic payments future damage awards


Summary: Seniors and Taxpayers Obligation Protection Act of 2009 - Directs the Secretary of Health and Human Services, in order to protect beneficiaries from identity theft, to establish and implement procedures to change the Medicare beneficiary identifier used to identify individuals entitled to benefits under part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act (SSA), or enrolled under part B (Supplementary Medical Insurance), so that such an individual's Social Security number is not used. Amends title II (Old Age, Survivors and Disability Insurance) of the Social Security Act to direct the Commissioner of Social Security, upon the Secretary's request, to enter into a data matching agreement with the Secretary to determine if individuals are eligible for benefits or if providers are eligible to provide services or supplies. Directs the Secretary to investigate claims involving certain individuals who are not eligible for benefits or are not eligible providers of services or suppliers. Amends SSA title XVIII to direct the Secretary to establish and implement a system to verify on a monthly basis that the claims for payment under Medicare part B for physicians' services furnished in high risk areas are: (1) for physicians' services actually furnished by the physician (or the physician's group practice); and (2) otherwise accurate. Requires the Secretary to establish a system to identify the 50 counties most vulnerable (high risk areas) to Medicare fraud. Directs the Secretary to establish procedures for the use of technology (similar to that used with respect to the analysis of credit card charging patterns) to provide real-time data analysis of claims for payment under the Medicare program to identify and investigate unusual billing or order practices under the Medicare program that could indicate fraud or abuse. Requires the Secretary to establish procedures to require carriers, before paying a claim for payment for durable medical equipment (DME), prosthetics, orthotics, and supplies (DMEPOS) to confirm with the National Supplier Clearinghouse that: (1) the physician's or practitioner's National Provider Identifier is valid and active; (2) the supplier's Medicare identification number is valid and active; and (3) that the item or service for which the claim for payment is submitted was properly identified on the CMS-855S Medicare enrollment application. Directs the Secretary to develop a strategic plan for the development and implementation of a serial number tracking system for DME, including mechanisms to ensure unique identifiers for DME items without them. Directs the Comptroller General to study and report to Congress on the effectiveness of the surety bond requirement for DME suppliers in combating fraud.

seniors taxpayers obligation protection act directs secretary health_and_human_services order protect beneficiaries identity theft establish implement procedures change medicare beneficiary identifier identify individuals entitled benefits title xviii medicare social security act ssa enrolled individual social_security number amends title old age survivors disability insurance social security act direct commissioner social_security secretary request enter data matching agreement secretary determine individuals eligible benefits providers eligible provide services supplies directs secretary investigate claims involving certain individuals eligible benefits eligible providers services suppliers amends ssa title xviii direct secretary establish implement system verify monthly basis claims payment medicare physicians services furnished high risk areas physicians services actually furnished physician physician group practice accurate requires secretary establish system identify counties vulnerable high risk areas medicare fraud directs secretary establish procedures use technology similar respect analysis credit card charging patterns provide real time data analysis claims payment medicare program identify investigate unusual billing order practices medicare program indicate fraud abuse requires secretary establish procedures require carriers paying claim payment durable medical equipment dme prosthetics orthotics supplies dmepos confirm physician practitioner national provider identifier valid active supplier medicare identification number valid active item service claim payment submitted properly identified medicare enrollment application directs secretary develop strategic plan development implementation serial number tracking system dme including mechanisms ensure unique identifiers dme items directs comptroller general study report congress effectiveness surety bond requirement dme suppliers combating fraud


Summary: Amends the Federal Torts Claim Act to extend medical malpractice coverage, treating the United States as liable, to free clinics and the officers, governing board members, employees, and contractors of free clinics in the same manner and extent as certain federal officers and employees.

amends extend medical malpractice coverage treating united_states liable free clinics officers governing board members employees contractors free clinics manner extent certain federal officers employees


Summary: Medical Liability Reform Act of 2009 - Sets forth provisions regulating lawsuits for health care liability claims related to the provision of health care services. Imposes no limitation on recoverable economic damages. Limits recoverable noneconomic damages with respect to the same occurrence to: (1) $250,000 from a provider or a single health care institution; and (2) $500,000 from multiple health institutions. Makes each party liable only for the amount of damages directly proportional to such party's percentage of responsibility. Prescribes qualifications for expert witnesses. Prohibits an expert witness from testifying if the witness's fee is contingent on the outcome of the lawsuit. Requires the claimant: (1) to certify with the claim whether expert opinion testimony is necessary to prove the health care professional's standard of care or liability for the claim; and (2) upon certifying that such testimony is necessary, to serve a preliminary expert opinion affidavit. Directs the court to dismiss the claim without prejudice if the claimant fails to serve a preliminary expert opinion affidavit after certifying that an affidavit is necessary or after the court has ordered the claimant to serve an affidavit. Sets forth provisions concerning: (1) the applicability of this Act to Public Health Service Act provisions pertaining to civil actions brought for a general vaccine or smallpox vaccine injury; and (2) preemption of state laws.

medical liability reform act sets forth provisions regulating lawsuits health care liability claims related provision health care services imposes limitation recoverable economic damages limits recoverable noneconomic damages respect occurrence provider single health care institution multiple health institutions makes party liable damages directly proportional party percentage responsibility prescribes qualifications expert witnesses prohibits expert witness witness fee contingent outcome lawsuit requires claimant certify claim expert opinion testimony necessary prove health care professional standard care liability claim certifying testimony necessary serve preliminary expert opinion affidavit directs court dismiss claim prejudice claimant fails serve preliminary expert opinion affidavit certifying affidavit necessary court ordered claimant serve affidavit sets forth provisions concerning applicability act public health service act provisions pertaining civil actions brought general vaccine vaccine injury preemption state laws


Summary: Health Care Fraud Enforcement Act of 2009 - Directs the United States Sentencing Commission to review and amend guidelines and policy statements relating to health care fraud to increase the sentences for such crimes based upon the dollar amount of fraud involved. Expands the definition of "health care fraud" to include anti-fraud provisions of the Social Security Act relating to kickbacks, bribes, or rebates, the Food, Drug and Cosmetic Act, and the Employee Retirement Income Security Act of 1974 (ERISA). Makes a health care fraud violation under such statutes a false or fraudulent claim for purposes of the False Claims Act. Amends the federal criminal code to allow a conviction for health care fraud without actual knowledge of a fraud prohibition or a specific intent to commit a health care fraud violation. Amends the Civil Rights of Institutionalized Persons Act to expand the power of the Attorney General to issue subpoenas for records under such Act. Authorizes additional appropriations to the Department of Justice (DOJ) for FY2011-FY2016 for investigations and prosecutions relating to fraud and abuse in connection with any health care benefit program.

directs united_states_sentencing_commission review amend guidelines policy statements relating health care fraud increase sentences crimes based dollar fraud involved expands definition health care fraud include anti fraud provisions social security act relating kickbacks rebates employee retirement income security act erisa makes health care fraud violation statutes false fraudulent claim purposes false claims act amends federal criminal code allow conviction health care fraud actual knowledge fraud prohibition specific intent commit health care fraud violation amends civil rights institutionalized persons act expand power attorney general issue subpoenas records act authorizes additional appropriations department_of_justice doj fy2011 fy2016 investigations prosecutions relating fraud abuse connection health care benefit program


Summary: Fair Resolution of Medical Liability Disputes Act of 2009 - Prohibits a medical malpractice action from being filed in a state court or a federal court under diversity of citizenship jurisdiction unless: (1) the claim that is the subject of the action has been initially resolved under an alternative dispute resolution (ADR) system; and (2) an affected party notifies the appropriate court of the intent to contest the decision and files the action within 90 days after such decision is issued. Provides: (1) for the payment of an opposing party's court costs and attorneys' fees by the contesting party in the case of a malpractice action brought in court after ADR if the final judgment issued in the action is not more favorable to the contesting party than the ADR decision; and (2) that an uncontested ADR decision shall have the status of a verdict in a court adjudicated action. Sets forth basic requirements for state ADR systems, including a requirement that they transmit to the state agency responsible for monitoring or disciplining health care providers any findings that a provider committed malpractice. Directs the Attorney General to: (1) certify state ADR systems that meet the requirements of this Act; and (2) establish an alternative federal ADR system for any state that does not establish its own system. Directs the Comptroller General to study the effectiveness of private litigation insurance markets in providing affordable access to courts, evaluating the merit of prospective claims, and ensuring that prevailing parties in "loser pays" systems are reimbursed for attorney's fees.

fair resolution medical liability disputes act prohibits medical malpractice action filed state court federal court diversity citizenship jurisdiction claim subject action initially resolved alternative dispute resolution system affected party notifies appropriate court intent contest decision files action days decision issued provides payment opposing party court costs attorneys fees contesting party case malpractice action brought court final judgment issued action favorable contesting party decision decision shall status court adjudicated action sets forth basic requirements state systems including requirement transmit state agency responsible monitoring disciplining health care providers findings provider committed malpractice directs attorney general certify state systems meet requirements act establish alternative federal system state establish system directs comptroller general study effectiveness private litigation insurance markets providing affordable access courts evaluating merit prospective claims ensuring prevailing parties pays systems reimbursed attorney fees


Summary: Fighting Medicare Payment Fraud Act of 2009 - Amends title XVIII (Medicare) to require the Secretary of Health and Human Services (HHS) to extend to up to 365 calendar days for particular categories of service providers or suppliers the number of days in which Medicare claims are required to be paid in order to ensure that they are clean claims. Limits such extension to categories of service providers or suppliers, such categories in a certain geographic area, or individual service providers or suppliers about which the Secretary has determined that there is a likelihood of fraud, waste, or abuse involving them.

fighting medicare payment fraud act amends title xviii medicare require secretary health_and_human_services hhs extend calendar days particular categories service providers suppliers number days medicare claims required paid order ensure clean claims limits extension categories service providers suppliers categories certain geographic area individual service providers suppliers secretary determined likelihood fraud waste abuse involving


Summary: Strengthening Program Integrity and Accountability in Health Care Act - Amends title XVIII (Medicare) of the Social Security Act (SSA) to direct the Secretary of Health and Human Services (HHS) to: (1) establish new procedures for screening providers and suppliers under Medicare, Medicaid (SSA title XIX), and the State Children's Health Insurance Program (CHIP, formerly known as SCHIP) (SSA title XXI); and (2) determine the level of screening according to the risk of fraud, waste, and abuse with respect to each category of provider or supplier. Requires providers and suppliers applying for enrollment or revalidation of enrollment in Medicare, Medicaid, or CHIP to disclose current or previous affiliations with any provider or supplier that has been sanctioned in specified ways. Requires providers and suppliers to establish a compliance program containing specified core elements. Directs the Administrator of the Centers for Medicare & Medicaid Services (CMS) to establish a process for making available to each state agency with responsibility for administering a state Medicaid plan or a child health plan under SSA title XXI the identity of any provider or supplier under Medicare or CHIP who is terminated. Requires CMS to include in the integrated data repository (IDR) claims and payment data from Medicare, Medicaid, CHIP, and health-related programs administered by the Departments of Veterans Affairs (VA) and of Defense (DOD), the Social Security Administration, and the Indian Health Service (IHS). Directs the Secretary to enter into data-sharing agreements with the Commissioner of Social Security, the VA and DOD Secretaries, and the IHS Director to help identify fraud, waste, and abuse. Requires that overpayments be reported and returned within a certain period of time. Directs the Secretary to issue a regulation requiring all Medicare, Medicaid, and CHIP providers to include their National Provider Identifiers on enrollment applications. Subjects to civil monetary penalties (CMPs) excluded individuals who: (1) order or prescribe an item or service; (2) make false statements on applications or contracts to participate in a federal health care program; or (3) know of an overpayment and do not return it. Requires the Secretary take into account the volume of billing for a durable medical equipment (DME) supplier or home health agency when determining the size of the supplier's and agency's surety bond. Requires the Secretary to suspend payment to a provider or supplier pending a fraud investigation. Extends the number of days in which Medicare claims must be paid if there is a likelihood of fraud involving certain providers or suppliers. Appropriates additional funds to the Health Care Fraud and Abuse Control Account. Requires the Medicare Integrity Program and the Medicaid Integrity Program to provide the Secretary and the HHS Office of Inspector General with performance statistics. Requires the Secretary to furnish the National Practitioner Data Bank with all information reported to the national health care fraud and abuse data collection program on certain final adverse actions taken against health care providers, suppliers, and practitioners. Reduces from three years to one year the maximum period for submission of Medicare claims. Requires DME or home health services to be ordered by an enrolled Medicare eligible professional or physician. Requires a physician, before issuing a certification for home health services, and a physician, a nurse practitioner, a clinical nurse specialist, a certified nurse-midwife, or a physician assistant, before ordering DME, to have a face-to-face encounter with the individual concerned. Revises certain CMPs for making false statements or delaying inspections. Requires the Secretary to establish a self-referral disclosure protocol to enable health care providers and suppliers to disclose actual or potential violations of the physician self-referral law. Requires states to establish contracts with one or more Recovery Audit Contractors (RACs). Directs the Secretary to expand the RAC Program to Medicare parts C (Medicare+Choice) and D (Prescription Drug Program). Directs the Secretary, acting through the CMS Administrator, to establish: (1) an information sharing program regarding beneficiary medical ID theft under Medicare, Medicaid, and CHIP; and (2) a clearinghouse at the CMS to collect reports of ID theft against beneficiaries. Amends SSA title XIX (Medicaid) to require states to terminate providers from Medicaid participation if they were terminated from Medicare or another state's Medicaid plan. Requires Medicaid agencies to exclude individuals or entities from Medicaid participation for a specified period of time if the entity or individual owns, controls, or manages an entity that: (1) has failed to repay overpayments during a specified period; (2) is suspended, excluded, or terminated from participation in any Medicaid program; or (3) is affiliated with an individual or entity that has been suspended, excluded, or terminated from Medicaid participation. Requires state Medicaid plans to require any billing agents, clearinghouses, or other alternate payees that submit claims on behalf of health care providers to register with the state and the Secretary. Requires states to submit data elements from the state mechanized claims processing and information retrieval system (under the Medicaid Statistical Information System [MSIS]) that the Secretary determines necessary for program integrity, program oversight, and administration. Requires a state Medicaid plan to prohibit the state from making any payments for items or services under a Medicaid state plan or a waiver to any financial institution or entity located outside of the United States. Extends the period for states to recover overpayments from 60 days to one year after discovery of the overpayment. Requires state mechanized Medicaid claims processing and information retrieval systems to incorporate methodologies compatible with Medicare's National Correct Coding Initiative. Amends the Federal Food, Drug, and Cosmetic Act to require listing on the Food and Drug Administration (FDA) website of drugs not required to be approved as new drugs or new animal drugs. Prohibits states from making Medicaid payments for any covered outpatient drug without first verifying FDA approval. Amends SSA title XI to require any individuals or entities participating in or conducting activities under federal health care programs to comply with certain congressional requests for documents, information, or interviews. Amends the False Claims Act to restrict the statute of limitations for civil actions under the Act to two years after a retaliation occurred. Revises requirements for dismissal of a claim or action based on public disclosure of the same allegations or transactions in other specified venues, including the news media.

title xviii medicare social security act ssa direct secretary health_and_human_services hhs establish new procedures screening providers suppliers medicare medicaid ssa title xix known schip ssa title xxi determine level screening according risk fraud waste abuse respect category provider supplier requires providers suppliers applying enrollment enrollment medicare medicaid chip disclose current previous affiliations provider supplier sanctioned specified ways requires providers suppliers establish compliance program containing specified core elements directs administrator centers cms establish process making available state agency responsibility administering state medicaid plan child health plan ssa title xxi identity provider supplier medicare chip terminated requires cms include integrated data repository claims payment data medicare medicaid chip health related programs administered departments_of_veterans_affairs defense dod social_security_administration indian_health_service ihs directs secretary enter data sharing agreements commissioner_of_social_security ihs director help identify fraud waste abuse requires overpayments reported returned certain period time directs secretary issue regulation requiring medicare medicaid chip providers include enrollment applications subjects civil monetary penalties excluded individuals order prescribe item service false statements applications contracts participate federal health care program know overpayment return requires secretary account volume billing durable medical equipment dme supplier home health agency determining size supplier agency surety bond requires secretary suspend payment provider supplier pending fraud investigation extends number days medicare claims paid likelihood fraud involving certain providers suppliers appropriates additional funds requires medicare_integrity_program medicaid_integrity_program provide secretary performance statistics requires secretary furnish national_practitioner_data_bank information reported national health care fraud abuse data collection program certain final adverse actions taken health care providers suppliers practitioners reduces years year maximum period submission medicare claims requires dme home health services ordered enrolled medicare eligible professional physician requires physician issuing certification home health services physician nurse practitioner clinical nurse specialist certified nurse midwife physician assistant ordering dme face face encounter individual concerned revises certain making false statements delaying inspections requires secretary establish self referral disclosure protocol enable health care providers suppliers disclose actual potential violations physician self referral law requires states establish contracts directs secretary expand medicare parts directs secretary acting establish information sharing program beneficiary medical theft medicare medicaid chip clearinghouse cms collect reports theft beneficiaries amends ssa title xix medicaid require states terminate providers medicaid participation terminated medicare state medicaid plan agencies exclude individuals entities medicaid participation specified period time entity individual owns controls manages entity failed repay overpayments specified period suspended excluded terminated participation medicaid program affiliated individual entity suspended excluded terminated medicaid participation requires state medicaid plans require billing agents clearinghouses alternate payees submit claims behalf health care providers register state secretary requires states submit data elements state mechanized claims processing information retrieval system msis secretary determines necessary program integrity program oversight administration requires state medicaid plan prohibit state making payments items services medicaid state plan waiver financial institution entity located outside united_states extends period states recover overpayments days year discovery overpayment requires state mechanized medicaid claims processing information retrieval systems incorporate methodologies compatible medicare amends cosmetic act require listing food_and_drug_administration fda website drugs required approved new drugs new animal drugs prohibits states making medicaid payments covered outpatient drug verifying fda approval amends ssa title require individuals entities participating conducting activities federal health care programs comply certain congressional requests documents information interviews amends false claims act restrict statute limitations civil actions act years retaliation occurred revises requirements dismissal claim action based public disclosure allegations transactions specified venues including news media


Summary: Remuneration for Ecological and Societal Tolls Occasioned by Reckless Errors Act or RESTORE Act - Repeals specified general limitations on liability (the Limitation of Liability Act) for personal injury or death, or loss or damage to merchandise due to fire, on seagoing vessels.

remuneration ecological reckless errors act restore act repeals specified general limitations liability limitation liability act personal injury death loss damage merchandise fire vessels


Summary: Medicare and Medicaid Fraud Enforcement and Prevention Act of 2010 - Amends title XI of the Social Security Act (SSA) to increase criminal penalties for both felony and misdemeanor fraud under SSA titles XVIII (Medicare) and XIX (Medicaid). Adds a new offense of distribution of one or more Medicare or Medicaid beneficiary identification numbers or billing privileges with the intent to defraud. Applies civil monetary penalties to: (1) conspiracy to make false statements or commit other specified offenses with respect to Medicare or Medicaid claims; and (2) knowing creation or use of false records or statements with respect to the transmission of money or property to a federal health care program. Extends the statute of limitations from six to 10 years after presentation of a claim. Amends SSA title XI, as amended by the Patient Protection and Affordable Care Act, with respect to the access to claims and payment data granted to the Inspector General of the Department of Health and Human Services (HHS). Requires the Inspector General to implement mechanisms for the sharing of information about suspected fraud relating to the federal health care programs under Medicare, Medicaid, and SSA title XXI (Children's Health Insurance Program) (CHIP) with other appropriate law enforcement officials. Directs the HHS Secretary to implement a five-year Beneficiary Verification Pilot Program to verify, with respect to Medicare claims, that the beneficiary for which the claim was made was actually furnished the claimed item or service. Requires the Comptroller General to study and report to Congress on Medicare administrative contractors, including Recovery Audit Contractors.

medicare amends title social security act ssa increase criminal penalties felony misdemeanor fraud ssa titles xviii medicare xix medicaid adds new offense distribution medicare medicaid beneficiary identification numbers billing privileges intent defraud applies civil monetary penalties conspiracy false statements commit specified offenses respect medicare medicaid claims knowing creation use false records statements respect transmission money property federal health care program extends statute limitations years presentation claim amends ssa title amended patient_protection affordable care act respect access claims payment data granted inspector general department health human services hhs requires inspector general implement mechanisms sharing information suspected fraud relating federal health care programs medicare medicaid ssa title chip appropriate law enforcement officials directs hhs secretary implement year beneficiary verification pilot program verify respect medicare claims beneficiary claim actually furnished claimed item service requires comptroller general study report congress medicare administrative contractors including