Summary: State Leadership in Health Care Act - Amends the Patient Protection and Affordable Care Act (PPACA) to allow states to apply for a waiver of specified requirements under PPACA with respect to health insurance coverage within that state due to implementation of a state plan that provides comparable coverage for plan years beginning in 2014 (currently, 2017).. Permits the Secretary of Health and Human Services (HHS) or the Secretary of the Treasury to deny waivers only if: (1) the state plan does not meet requirements for granting a waiver; (2) the Secretary of HHS or Treasury notifies the state in writing of the requirements that the state plan did not meet and provides the state with information used in making such a determination; and (3) the state is given an opportunity to appeal. Requires the Secretary of HHS or Treasury to reconsider the determination in the event of an appeal.

state leadership health care act amends patient protection affordable care act ppaca allow states apply waiver specified requirements ppaca respect health insurance coverage state implementation state plan provides comparable coverage plan years beginning currently permits secretary health_and_human_services hhs secretary treasury deny waivers state plan meet requirements granting waiver secretary hhs treasury notifies state writing requirements state plan meet provides state information making determination state given opportunity appeal requires secretary hhs treasury reconsider determination event appeal


Summary: Protecting Access to Healthcare Act - Title I: HEALTH Act - Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2012 - (Sec. 101) Sets forth provisions regulating lawsuits for health care liability claims concerning the provision of health care goods or services or any medical product affecting interstate commerce. (Sec. 103) 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. (Sec. 104) 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. (Sec. 105) 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. (Sec. 106) 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. Limits the liability of manufacturers, distributors, suppliers, and providers of medical products that comply with Food and Drug Administration (FDA) standards. (Sec. 107) Provides for periodic payments of future damage awards. (Sec. 110) Declares that this title does not: (1) preempt or supersede any state or federal law that imposes greater procedural or substantive protections for health care providers or health care organizations from liability, loss, or damages than those provided by this title; or (2) create a cause of action. Declares that this title shall not be construed to preempt: (1) any state law that specifies a particular monetary amount of compensatory or punitive damages that may be awarded in a health care lawsuit, or (2) any defense available to a party in a health care lawsuit under any other provision of state or federal law. Title II: Repeal of Independent Payment Advisory Board - Medicare Decisions Accountability Act of 2012 - (Sec. 202) Repeals sections of the Patient Protection and Affordable Care Act (and restores provisions of law amended by such sections) related to the establishment of an Independent Payment Advisory Board (IPAB) to develop and submit detailed proposals to reduce the per capita rate of growth in Medicare spending. Title III: Health Care Safety Net Enhancement - Health Care Safety Net Enhancement Act of 2012 - (Sec. 302) Amends the Public Health Service Act to deem a hospital or an emergency department and a physician or physician group of such hospital or emergency department to be an employee of the Public Health Service for purposes of any civil action that may arise due to providing emergency and post-stabilization services on or after January 1, 2012. Title IV: Restoring the Application of Antitrust Laws to Health Sector Insurers - Health Insurance Industry Fair Competition Act of 2012 - (Sec. 402) Provides that nothing in the McCarran-Ferguson Act shall modify, impair, or supersede the operation of any of the antitrust laws with respect to the business of health insurance. Applies prohibitions against using unfair methods of competition to the business of health insurance without regard to whether such business is carried on for profit. Title V: Protections for Good Samaritan Health Professionals - Good Samaritan Health Professionals Act of 2012 - (Sec. 502) Amends the Public Health Service Act to provide that a health care professional shall not be liable under federal or state law for harm caused by any act or omission if: (1) the professional is serving as a volunteer for purposes of responding to a disaster; and (2) the act or omission occurs during the period of the disaster, in the professional's capacity as such a volunteer, and in a good faith belief that the individual being treated is in need of health care services. Makes exceptions where: (1) the harm was caused by an act or omission constituting willful or criminal misconduct, gross negligence, reckless misconduct, or a conscious flagrant indifference to the rights or safety of the individual harmed; or (2) the professional rendered the health care services under the influence of intoxicating alcohol or an intoxicating drug. Places on the plaintiff in any civil action or proceeding against a health care professional the burden of proving by clear and convincing evidence that the limitation of liability under this title does not apply.

health act help efficient accessible low cost timely healthcare health act sec sets forth provisions regulating lawsuits health care liability claims concerning provision health care goods services medical product affecting interstate commerce sec sets statute limitations years date manifestation injury year claimant discovers injury certain exceptions sec limits noneconomic damages makes party liable damages directly proportional party percentage responsibility sec allows court restrict payment attorney contingency fees limits fees decreasing percentage based increasing value awarded sec 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 limits liability manufacturers distributors suppliers providers medical products comply food_and_drug_administration fda standards sec provides periodic payments future damage awards sec declares title preempt supersede state federal law imposes greater procedural substantive protections health care providers health care organizations liability loss damages provided title create cause action declares title shall construed preempt state law specifies particular monetary compensatory punitive damages awarded health care lawsuit defense available party health care lawsuit provision state federal law title repeal independent payment advisory board medicare decisions accountability act sec repeals sections patient_protection affordable care act restores provisions law amended sections related establishment independent_payment_advisory_board develop submit detailed proposals reduce capita rate growth medicare spending title iii sec amends public_health_service_act deem hospital emergency department physician physician group hospital emergency department employee public_health_service purposes civil action arise providing emergency post stabilization services january title restoring application antitrust laws health sector insurers health insurance industry fair competition act sec provides mccarran ferguson act shall modify impair supersede operation antitrust laws respect business health insurance applies prohibitions unfair methods competition business health insurance regard business carried profit title protections good samaritan health professionals good samaritan health professionals act sec amends public_health_service_act provide health care professional shall liable federal state law harm caused act omission professional serving volunteer purposes responding disaster act omission occurs period disaster professional capacity volunteer good faith belief individual treated need health care services makes exceptions harm caused act omission constituting willful criminal misconduct gross negligence reckless misconduct conscious flagrant indifference rights safety individual harmed professional rendered health care services influence intoxicating alcohol intoxicating drug places plaintiff civil action proceeding health care professional burden proving clear convincing evidence limitation liability title apply


Summary: Medicare Fraud Prevention Act of 2011 - 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: Healthcare Truth and Transparency Act of 2011 - Prohibits any person from making any deceptive or misleading statement, or engaging in any deceptive or misleading act, that: (1) misrepresents whether such person holds a state health care license; or (2) misrepresents such person's education, training, degree, license, or clinical expertise. Requires any person who is advertising health care services provided by such person to disclose the applicable license under which such person is authorized to provide those services. Deems a violation of this Act to be an unfair or deceptive act or practice under the Federal Trade Commission Act. Directs the Federal Trade Commission (FTC) to study and report to Congress on health care professionals' misrepresentations under this Act. Declares that nothing in this Act shall be construed or have the effect of changing state scope of practice for any health care professional.

transparency_act prohibits person making deceptive misleading statement engaging deceptive misleading act misrepresents person holds state health care license misrepresents person education training degree license clinical expertise requires person advertising health care services provided person disclose applicable license person authorized provide services deems violation act unfair deceptive act practice federal_trade_commission_act directs federal_trade_commission ftc study report congress health care professionals misrepresentations act declares act shall construed effect changing state scope practice health care professional


Summary: Consumer Protection Act of 2011 - Invalidates as a defense to a tort claim in any court in the United States that a manufacturer of a product has fulfilled that manufacturer's duty of care when providing all of the necessary information to a learned intermediary, who then interacts with the consumer of the product. Defines a "learned intermediary" as a person licensed under applicable state or federal law to advise a consumer whether or not to use the product in question.

consumer protection act invalidates defense tort claim court united_states manufacturer product fulfilled manufacturer duty care providing necessary information learned intermediary consumer product defines learned intermediary person licensed applicable state federal law advise consumer use product question


Summary: Amends the Antiquities Act of 1906 to require, in addition to a presidential declaration, congressional approval prior to the establishment of a national monument.

amends antiquities act require addition presidential declaration congressional approval prior establishment national monument


Summary: Residential and Commuter Toll Fairness Act of 2012 - Grants state, county, and municipal governments, as well as multi-jurisdictional transportation authorities that operate or manage roads, bridges, railroads, buses, ferries, or other transportation systems, rulemaking authority to establish toll, user fee, or fare discount programs for their local residents or commuters.

residential commuter toll fairness act grants state county municipal governments multi jurisdictional transportation authorities operate manage roads bridges railroads buses ferries transportation systems rulemaking authority establish toll user fee fare discount programs local residents commuters


Summary: Medicare Information Act of 2011 - Amends part A of title XI of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to provide to each eligible individual annually a statement of Medicare part A (Hospital Insurance) contributions and benefits in coordination with the annual mailing of Social Security account statements.

medicare information act amends title social security act direct secretary health_and_human_services hhs provide eligible individual annually statement medicare contributions benefits coordination annual mailing social_security account statements


Summary: Family Health Care Accessibility Act of 2011 - 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; and (2) the health care practitioner does not receive any compensation for providing the service, except repayment for reasonable expenses. Considers an entity as sponsoring the health care practitioner if the entity submits an application to the Secretary of Health and Human Services (HHS), and 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 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 annually. 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, 2012.

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 health care practitioner receive compensation providing service repayment reasonable expenses considers entity sponsoring health care practitioner entity submits application secretary health_and_human_services hhs secretary determines health care practitioner deemed employee public_health_service requires attorney general submit congress estimate claims related fees expenses witnesses reason actions omissions health professional volunteers paid pursuant act annually requires secretary transfer estimated claims fund appropriate accounts treasury subject extent amounts fund makes act effective october


Summary: Ending Defensive Medicine and Encouraging Innovative Reforms Act of 2011 - Sets conditions for lawsuits arising from health care liability claims regarding health care goods or services or any medical product affecting interstate commerce. Provides for periodic payment of future damages. Makes each party liable only for the amount of damages directly proportional to such party's percentage of responsibility. Requires the dismissal of any lawsuit for which a qualified specialist does not submit an affidavit to the court as to whether there is a reasonable and meritorious cause for filing the action. Requires the claimant to pay the defendant's reasonable costs and attorney fees, under certain circumstances. Absolves health care providers from liability if such providers acted consistent with accepted clinical practice guidelines. Amends the Public Health Service Act to extend liability protections for employees of the Public Health Service to certain emergency medical personnel and health center volunteer practitioners. Protects disaster relief volunteers, nonprofit organizations, and other entities from civil liability for injuries related to disaster relief services or donated goods, except for injuries caused by willful, wanton, or reckless misconduct. Makes a state that has enacted and is implementing an alternative medical liability law eligible to receive an incentive payment from the Secretary of Health and Human Services (HHS). Subjects health care lawsuits in a state receiving an incentive payment to liability limits and other provisions governing health care liability claims if the state's alternative medical liability laws have not brought about a reduction in the number of health care lawsuits in the state, a reduction in the amount of time required to resolve lawsuits in the state, and a reduction in the cost of malpractice insurance in the state.

reforms act sets conditions lawsuits arising health care liability claims health care goods services medical product affecting interstate commerce provides periodic payment future damages makes party liable damages directly proportional party percentage responsibility requires dismissal lawsuit qualified specialist submit affidavit court reasonable meritorious cause filing action requires claimant pay defendant reasonable costs attorney fees certain circumstances absolves health care providers liability providers acted consistent accepted clinical practice guidelines amends public_health_service_act extend liability protections employees public_health_service certain emergency medical personnel health center volunteer practitioners protects disaster relief volunteers nonprofit organizations entities civil liability injuries related disaster relief services donated goods injuries caused willful wanton reckless misconduct makes state enacted implementing alternative medical liability law eligible receive incentive payment secretary health_and_human_services hhs subjects health care lawsuits state receiving incentive payment liability limits provisions governing health care liability claims state alternative medical liability laws brought reduction number health care lawsuits state reduction time required resolve lawsuits state reduction cost malpractice insurance state


Summary: Medicare Common Access Card Act of 2011 - Establishes a pilot program under title XVIII (Medicare) of the Social Security Act in order to utilize smart card technology for Medicare beneficiary and provider identification cards.

medicare common access card act establishes pilot program title xviii medicare social security act order utilize smart card technology medicare beneficiary provider identification cards


Summary: Requires any employee of the Veterans Health Administration who, while working in a Department of Veterans Affairs (VA) medical facility, intentionally fails to follow infection control practices to be fined in accordance with the federal criminal code or imprisoned for up to one year, or both. Directs the Secretary of Veterans Affairs to establish infection control practices.

requires employee veterans_health_administration working department_of_veterans_affairs medical facility intentionally fails follow infection control practices fined accordance federal criminal code imprisoned year directs secretary veterans_affairs establish infection control practices


Summary: Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act or Medicare and Medicaid FAST Act - Amends part D (Prescription Drug Benefits) of title XVIII (Medicare) of the Social Security Act (SSA) to direct the Secretary of Health and Human Services (HHS) to prohibit sponsors of prescription drug plans (PDPs) from paying claims for prescription drugs that do not include the valid National Provider Identifier for the drug's prescriber. Directs the Secretary of HHS to establish procedures and rules to restrict access to the National Provider Identifier Registry in order to deter fraudulent use of it. Amends SSA title XIX (Medicaid), for any state that has established a State Prescription Drug Monitoring Program meeting certain requirements, to decrease by 10% the federal medical assistance percentage (FMAP) with respect to any amounts recovered by or paid to the state related to an overpayment due to fraud, waste, or abuse. Allows the state to use such amounts to support its State Prescription Drug Monitoring Program. Directs the Secretary of HHS and the Attorney General jointly to establish a Commission to examine interoperability and other issues related to State Prescription Drug Monitoring Programs. Directs the Attorney General to: (1) update daily the Drug Enforcement Agency (DEA) database of persons registered to manufacture, distribute, or dispense a controlled substance under the Controlled Substances Act to reflect any changes in the information in the Death Master File of the Social Security Administration; (2) agree with the Commissioner of Social Security to obtain death information in order to update such database; (3) establish procedures and rules to restrict access to the database to deter its fraudulent use; and (4) establish procedures and rules to review and investigate pharmacy claims under Medicare part D that contain a registration number not assigned to a practitioner by the Attorney General under the Controlled Substances Act. Amends SSA title XVIII to require certain annual reports to describe the types and financial costs to the Medicare program of improper payment vulnerabilities identified by Recovery Audit Contractors (RACs). Requires the Secretary of HHS to develop a plan to revise the beneficiary incentive program under the Health Instance Portability and Accountability Act of 1996 (HIPAA) to encourage greater participation by individuals in reporting fraud and abuse in the Medicare program. Requires the Secretary of HHS to: (1) establish and implement procedures to eliminate the unnecessary collection, use, and display of Social Security account numbers of Medicare beneficiaries; and (2) ensure that each newly issued Medicare identification card meets specified requirements. Directs the Secretary of HHS to establish a pilot program utilizing smart card technology to evaluate its applicability to the Medicare program and whether such cards would be effective in preventing Medicare fraud. Directs the Secretary of HHS to establish policies and procedures for a process to require prior authorization for initial claims for reimbursement for standard power wheelchairs. Requires the Secretary of HHS, the HHS Inspector General, and the Attorney General to increase coordination and data sharing. Directs the Secretary of HHS to establish: (1) automated prepayment review of all Medicare claims, (2) a plan to facilitate the inclusion of states in the Medicare-Medicaid Data Match Program, and (3) a plan that allows each state Medicaid agency access to relevant data on improper or erroneous Medicare payments for items or services for dual eligible individuals. Prohibits Medicaid payments as well as payments under SSA title XXI (State Children's Health Insurance Program) (CHIP) unless a claim contains a valid beneficiary identification number and a valid National Provider Identifier. Directs the Secretary to establish Medicare administrative contractor error reduction incentives. Requires the provider enrollment process and provider screening to be separate from any contract to serve as a Medicare administrative contractor. Directs the Secretary of HHS to report to Congress on measurable metrics for improving Medicare contractor performance. Amends SSA title XI to establish penalties for the illegal distribution of a Medicare, Medicaid, or CHIP beneficiary identification number or billing privileges.

medicare medicare medicaid fast act_-_amends prescription drug benefits title xviii medicare social security act ssa direct secretary health_and_human_services hhs prohibit sponsors prescription drug plans pdps paying claims prescription drugs include valid national provider identifier drug prescriber directs secretary hhs establish procedures rules restrict access order deter fraudulent use amends ssa title xix medicaid state established meeting certain requirements decrease federal medical assistance percentage fmap respect amounts recovered paid state related overpayment fraud waste abuse allows state use amounts support state prescription drug monitoring program directs secretary hhs attorney general jointly establish commission examine interoperability issues related state prescription drug monitoring programs directs attorney general update daily dea database persons registered manufacture distribute dispense controlled substance controlled substances act reflect changes information death master file social_security_administration agree commissioner_of_social_security obtain death information order update database establish procedures rules restrict access database deter fraudulent use establish procedures rules review investigate pharmacy claims medicare contain registration number assigned practitioner attorney general controlled substances act amends ssa title xviii require certain annual reports describe types financial costs medicare program improper payment vulnerabilities identified requires secretary hhs develop plan revise beneficiary incentive program hipaa encourage greater participation individuals reporting fraud abuse medicare program requires secretary hhs establish implement procedures eliminate unnecessary collection use display social_security account numbers medicare beneficiaries ensure newly issued medicare identification card meets specified requirements directs secretary hhs establish pilot program utilizing smart card technology evaluate applicability medicare program cards effective preventing medicare fraud directs secretary hhs establish policies procedures process require prior authorization initial claims reimbursement standard power wheelchairs requires secretary hhs attorney general increase coordination data sharing directs secretary hhs establish automated prepayment review medicare claims plan facilitate inclusion states medicare-medicaid data_match_program plan allows state medicaid agency access relevant data improper erroneous medicare payments items services dual eligible individuals prohibits medicaid payments payments ssa title chip claim contains valid beneficiary identification number valid national provider identifier directs secretary establish medicare administrative contractor error reduction incentives requires provider enrollment process provider screening separate contract serve medicare administrative contractor directs secretary hhs report congress measurable metrics improving medicare contractor performance amends ssa title establish penalties illegal distribution medicare medicaid chip beneficiary identification number billing privileges


Summary: Promoting Responsibility in Medical Expenditures Act of 2011 - 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. Directs the Secretary of Health and Human Services to submit to Congress annual fraud reports with respect to Medicare, SSA title XIX (Medicaid), and SSA title XXI (Children's Health Insurance) (CHIP). Amends the Small Business Jobs Act to exempt from disclosure under the Freedom of Information Act the algorithms used in predictive modeling and other analytics technology to identify and prevent waste, fraud, and abuse in the Medicare fee-for-service program. Requires valid National Provider Identifiers for prescribers on pharmacy claims for covered Medicare part D prescription drugs. Requires a prescription drug plan (PDP) sponsor identifying a claim for reimbursement for a drug prescribed by an individual without a valid National Provider Identifier to report to the HHS Inspector General any relevant information on such a prescriber, including any invalid national provider identifiers being used to submit such claims and related records. Requires the Inspector General of HHS to provide such information to appropriate law enforcement agencies. Directs the Secretary of HHS to establish procedures and rules to restrict access to the National Provider Identifier Registry in order to deter the fraudulent use of National Provider Identifiers. Decreases by 10% per quarter the federal medical assistance percentage (FMAP) for a state if: (1) it is receiving a grant for a state controlled substance monitoring program through which it identifies fraud, waste, or abuse in connection with the provision of prescription drug coverage under the state Medicaid plan; and (2) the state or a political subdivision is reimbursed by a third party for expenditures related to such fraud, waste, or abuse, or for a recovered amount. Directs the Secretary of HHS to establish procedures to eliminate the unnecessary collection, use, and display of Social Security account numbers of Medicare beneficiaries. Requires the Secretary of HHS to ensure that each newly issued Medicare identification card does not display or electronically store, in an unencrypted format, a Medicare beneficiary's Social Security account number, unless the beneficiary's health insurance claim number is the beneficiary's or spouse's Social Security number, and the risk of fraudulent use of such numbers is not unacceptably high. Requires the Secretary of HHS to prohibit the display of a Medicare beneficiary's Social Security account number in any written or electronic communication to the beneficiary unless its inclusion is essential for the operation of the Medicare program. Directs the Secretary of HHS to establish a pilot program to evaluate the applicability of smart card technology to the Medicare program, and whether such cards would be effective in preventing Medicare fraud. Prohibits payment for an item or service under Medicaid or CHIP unless the claim contains: (1) a valid beneficiary identification number corresponding to an individual enrolled under the state plan or an applicable waiver; and (2) a valid provider identifier corresponding to a provider eligible to receive payment for furnishing such item or service. Directs the Comptroller General to recommend methods to make Medicare claims data available to the public to improve Medicare transparency while protecting the privacy of individual Medicare beneficiaries, service providers, and suppliers.

promoting responsibility medical expenditures act amends title social security act ssa increase civil money penalties criminal fines prison sentences fraud abuse ssa title xviii medicare program directs secretary health_and_human_services submit congress annual fraud reports respect medicare ssa title xix medicaid ssa title chip amends small_business_jobs_act exempt disclosure freedom information act predictive modeling analytics technology identify prevent waste fraud abuse medicare fee service program requires valid national provider identifiers prescribers pharmacy claims covered medicare prescription drugs requires prescription drug plan pdp sponsor identifying claim reimbursement drug prescribed individual valid national provider identifier report hhs_inspector general relevant information prescriber including invalid national provider identifiers submit claims related records requires inspector general hhs provide information appropriate law enforcement agencies directs secretary hhs establish procedures rules restrict access order deter fraudulent use decreases quarter federal medical assistance percentage fmap state receiving grant state controlled substance monitoring program identifies fraud waste abuse connection provision prescription drug coverage state medicaid plan state political subdivision reimbursed party expenditures related fraud waste abuse recovered directs secretary hhs establish procedures eliminate unnecessary collection use display social_security account numbers medicare beneficiaries requires secretary hhs ensure newly issued medicare identification card display electronically store unencrypted format medicare beneficiary social_security account number beneficiary health insurance claim number beneficiary spouse social_security number risk fraudulent use numbers high requires secretary hhs prohibit display medicare beneficiary social_security account number written electronic communication beneficiary inclusion essential operation medicare program directs secretary hhs establish pilot program evaluate applicability smart card technology medicare program cards effective preventing medicare fraud prohibits payment item service medicaid chip claim contains valid beneficiary identification number corresponding individual enrolled state plan applicable waiver valid provider identifier corresponding provider eligible receive payment furnishing item service directs comptroller general recommend methods medicare claims data available public improve medicare transparency protecting privacy individual medicare beneficiaries service providers suppliers


Summary: Cardiac Arrest Survival Act of 2011 - Amends the Public Health Service Act to expand immunity from civil liability related to automated external defibrillator devices (AEDs), including by giving immunity to: (1) a person who owns, occupies, or manages the premises from which an AED is taken or at which an AED is used or attempted to be used on a victim of a perceived medical emergency; and (2) the owner-acquirer of an AED for any harm resulting from the use or attempted use of such device, unless the harm was proximately caused by the failure of the owner-acquirer to properly maintain the device according to the guidelines of the device manufacturer. Applies immunity regardless of whether: (1) the AED is marked with cautionary signage or registered with any government; or (2) the person who used or attempted to use the AED complied with such signage, had received training on such use, or was assisted or supervised by any other person, including a licensed physician.

cardiac arrest survival act amends public_health_service_act expand immunity civil liability related automated external devices aeds including giving immunity person owns occupies manages premises aed taken aed attempted victim perceived medical emergency owner aed harm resulting use attempted use device harm proximately caused failure owner properly maintain device according guidelines device manufacturer applies immunity regardless aed marked cautionary signage registered government person attempted use aed complied signage received training use assisted supervised person including licensed physician


Summary: Good Samaritan Health Professionals Act of 2011 - Amends the Public Health Service Act to provide that a health care professional shall not be liable under federal or state law for harm caused by any act or omission if: (1) the professional is serving as a volunteer for purposes of responding to a disaster; and (2) the act or omission occurs during the period of the disaster, in the professional's capacity as such a volunteer, and in a good faith belief that the individual being treated is in need of health care services. Makes exceptions where: (1) the harm was caused by an act or omission constituting willful or criminal misconduct, gross negligence, reckless misconduct, or a conscious flagrant indifference to the rights or safety of the individual harmed; or (2) the professional rendered the health care services under the influence of intoxicating alcohol or an intoxicating drug.

good samaritan health professionals act amends public_health_service_act provide health care professional shall liable federal state law harm caused act omission professional serving volunteer purposes responding disaster act omission occurs period disaster professional capacity volunteer good faith belief individual treated need health care services makes exceptions harm caused act omission constituting willful criminal misconduct gross negligence reckless misconduct conscious flagrant indifference rights safety individual harmed professional rendered health care services influence intoxicating alcohol intoxicating drug


Summary: Medicare Fraud Enforcement and Prevention Act of 2011 - 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.

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


Summary: Strengthening and Focusing Enforcement to Deter Organized Stealing and Enhance Safety Act of 2012 or the SAFE DOSES Act - Amends the federal criminal code to prohibit, in or using any means or facility of interstate or foreign commerce: (1) embezzling, stealing, obtaining by fraud or deception, or knowingly and unlawfully taking, carrying away, or concealing a medical product that has not yet been made available for retail purchase by a consumer (pre-retail medical product); (2) knowingly and falsely making, altering, forging, or counterfeiting the labeling or documentation of such a product; (3) knowingly possessing, transporting, or trafficking in a product involved in such a violation; (4) buying or otherwise obtaining, or selling or distributing, with intent to defraud, such a product that has expired or been stolen; or (5) attempting or conspiring to commit such a violation. Makes such a violation an aggravated offense if: (1) the defendant is employed by, or is an agent of, an organization in the supply chain for the product; or (2) the violation involves the use of violence, force, a threat of violence or force, or the use of a deadly weapon, results in serious bodily injury or death, or is subsequent to a prior conviction for an offense under this Act. Prescribes criminal and civil penalties for violations, including a civil penalty of up to the greater of 3 times the economic loss attributable to the violation or $1 million. Provides for civil forfeiture for any property which constitutes or is derived from proceeds traceable to such a violation. Requires the penalties under this Act to apply for the following offenses involving a pre-retail medical product: (1) interstate and foreign travel or transportation in aid of racketeering enterprises; (2) engaging in monetary transactions in property derived from specified unlawful activity; (3) breaking into or entering carrier facilities with intent to commit larceny; and (4) the transportation, sale, or receipt of stolen property. Directs the Attorney General to give increased priority to efforts to investigate and prosecute offenses involving pre-retail medical products. Extends provisions authorizing wiretapping and requiring victim restitution to offenses relating to theft of a pre-retail medical product. Directs the U.S. Sentencing Commission to review and, if appropriate, amend the sentencing guidelines and policy statements applicable to offenses related to pre-retail medical product theft or robberies and burglaries involving controlled substances to reflect congressional intent that penalties are sufficient to deter and punish such offenses and to appropriately account for actual harm to the public.

strengthening focusing enforcement deter organized stealing enhance safety act safe doses act amends federal criminal code prohibit means facility interstate foreign commerce stealing obtaining fraud deception knowingly unlawfully taking carrying away concealing medical product available retail purchase consumer pre retail medical product knowingly falsely making altering counterfeiting labeling documentation product knowingly possessing transporting trafficking product involved violation buying obtaining selling distributing intent defraud product expired stolen attempting conspiring commit violation makes violation aggravated offense defendant employed agent organization supply chain product violation involves use violence force threat violence force use deadly weapon results bodily injury death subsequent prior conviction offense act prescribes criminal civil penalties violations including civil penalty greater times economic loss attributable violation million provides civil forfeiture property constitutes derived proceeds traceable violation requires penalties act apply following offenses involving pre retail medical product interstate foreign travel transportation aid racketeering enterprises engaging monetary transactions property derived specified unlawful activity breaking entering carrier facilities intent commit transportation sale receipt stolen property directs attorney general increased priority efforts investigate prosecute offenses involving pre retail medical products extends provisions authorizing requiring victim restitution offenses relating theft pre retail medical product directs review appropriate amend sentencing guidelines policy statements applicable offenses related pre retail medical product theft involving controlled substances reflect congressional intent penalties sufficient deter punish offenses appropriately account actual harm public


Summary: Stop Medicare Fraud Act of 2012 - Amends title XI of the Social Security Act (SSA) to increase the civil and criminal penalty levels for fraud under SSA title XVIII (Medicare).

stop medicare fraud act amends title social security act ssa increase civil criminal penalty levels fraud ssa title xviii medicare


Summary: Local Medicaid Enforcement Incentives Act of 2012 - Directs the Secretary of Health and Human Services (HHS) to establish a grant program to provide states with funds to: (1) detect and prevent Medicaid fraud, waste, and abuse; (2) recover overpayments to individuals or entities receiving Medicaid funds that result from such fraud, waste, or abuse; and (3) share with localities within the state that assist in such detection and prevention, or the recovery of such overpayments, at least 50% of the state's share of the total overpayments recovered during a period, minus administrative costs.

local directs secretary health_and_human_services hhs establish grant program provide states funds detect prevent medicaid fraud waste abuse recover overpayments individuals entities receiving medicaid funds result fraud waste abuse share localities state assist detection prevention recovery overpayments state share total overpayments recovered period minus administrative costs


Summary: Medical Care Access Protection Act of 2011 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: Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2011 - 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. 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 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: Strengthening Program Integrity and Accountability in Health Care Act of 2011 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to: (1) change from discretionary to mandatory the authority of the Secretary of Health and Human Services (HHS) to suspend Medicare and Medicaid payments pending investigation of credible allegations of fraud; and (2) require the Secretary to extend to up to 365 calendar days for particular categories of service providers or suppliers in which fraud, waste, or abuse is likely the number of days in which Medicare claims are required to be paid in order to ensure that they are clean claims. Requires the Inspector General of HHS to notify the relevant congressional committees within 30 days after transmitting to another HHS agency a management implication report (which details investigative findings about the possible implication of agency management in prohibited or otherwise inappropriate transactions). Directs the Secretary, acting through the Administrator of the Centers for Medicare & Medicaid Services, to establish an information sharing program regarding beneficiary medical ID theft under the programs under SSA titles XVIII (Medicare), XIX (Medicaid), and XXI (State Children's Health Insurance) (CHIP). Amends SSA title XI to authorize the Secretary to exclude from federal health care programs entities affiliated with a sanctioned entity, as well as any officer or managing employee of an affiliated entity (currently, only individuals with an ownership or control interest in a sanctioned entity), if the affiliated entity was so affiliated at the time of any of the conduct forming the basis for the conviction or exclusion of the sanctioned entity. Directs the Secretary to make available to the public Medicare claims and payment data. Amends SSA title XIX to require a state Medicaid agency to exclude from program participation with respect to a particular period any individual or entity which owns, controls, or manages an entity that: (1) has delinquent unpaid overpayments during such period; (2) is suspended or excluded from Medicaid participation or whose participation is terminated; or (3) is affiliated with an individual or entity that has been suspended or excluded from Medicaid participation or whose participation is terminated. Amends the Federal Food, Drug, and Cosmetic Act to require the Secretary to list on the Food and Drug Administration (FDA) Internet website certain new drugs (for human consumption) or new animal drugs that have not been approved by the FDA, together with the name of the person who listed such drug and the authority under such Act that does not require such drug to be subject to FDA approval. Amends SSA title XIX to prohibit a state from making a Medicaid payment for a covered outpatient drug which has not been FDA-approved. Amends SSA title XI to require individuals or entities that participate in or conduct activities under federal health care programs to comply with certain congressional requests for documents, information, or interviews.

amends title xviii medicare social security act ssa change discretionary mandatory authority secretary health_and_human_services hhs suspend medicare medicaid payments pending investigation credible allegations fraud require secretary extend calendar days particular categories service providers suppliers fraud waste abuse likely number days medicare claims required paid order ensure clean claims requires inspector general hhs notify relevant congressional committees days transmitting hhs agency management report details investigative findings possible agency management prohibited inappropriate transactions directs secretary acting administrator centers establish information sharing program beneficiary medical theft programs ssa titles xviii medicare xix medicaid chip amends ssa title authorize secretary exclude federal health care programs entities affiliated sanctioned entity officer managing employee affiliated entity currently individuals ownership control interest sanctioned entity affiliated entity affiliated time conduct forming basis conviction exclusion sanctioned entity directs secretary available public medicare claims payment data amends ssa title xix require state medicaid agency exclude program participation respect particular period individual entity owns controls manages entity delinquent unpaid overpayments period suspended excluded medicaid participation participation terminated affiliated individual entity suspended excluded medicaid participation participation terminated amends cosmetic act require secretary list food_and_drug_administration fda internet website certain new drugs human consumption new animal drugs approved fda person listed drug authority act require drug subject fda approval amends ssa title xix prohibit state making medicaid payment covered outpatient drug fda approved amends ssa title require individuals entities participate conduct activities federal health care programs comply certain congressional requests documents information interviews


Summary: Medicare Spending Transparency Act of 2011 - Amends title XI of the Social Security Act (SSA) to direct the Secretary of Health and Human Services (HHS), consistent with applicable information, privacy, security, and disclosure laws, to make public on the Internet website of the Centers for Medicare and Medicaid Services the following data with respect to SSA title XVIII (Medicare): (1) a complete list of service providers and suppliers participating in the Medicare program, including their business addresses; and (2) certain aggregate information about each provider and supplier. Entitles a qualified individual or group, for health research and fraud detection purposes, to access to Medicare claims and payment data of both HHS and its contractors. Directs the Secretary to establish procedures for the storage and use of data provided to such an individual or group.

medicare spending transparency act amends title social security act ssa direct secretary health_and_human_services hhs consistent applicable information privacy security disclosure laws public internet website centers medicare medicaid_services following data respect ssa title xviii medicare complete list service providers suppliers participating medicare program including business addresses certain aggregate information provider supplier entitles qualified individual group health research fraud detection purposes access medicare claims payment data hhs contractors directs secretary establish procedures storage use data provided individual group


Summary: Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act or Medicare and Medicaid FAST Act - Amends part D (Prescription Drug Benefits) of title XVIII (Medicare) of the Social Security Act (SSA) to direct the Secretary of Health and Human Services (HHS) to prohibit sponsors of prescription drug plans (PDPs) from paying claims for prescription drugs that do not include the valid National Provider Identifier for the drug's prescriber. Directs the Secretary of HHS to establish procedures and rules to restrict access to the National Provider Identifier Registry in order to deter fraudulent use of it. Amends SSA title XIX (Medicaid), for any state that has established a State Prescription Drug Monitoring Program meeting certain requirements, to decrease by 10% the federal medical assistance percentage (FMAP) with respect to any amounts recovered by or paid to the state related to an overpayment due to fraud, waste, or abuse. Allows the state to use such amounts to support its State Prescription Drug Monitoring Program. Directs the Secretary of HHS and the Attorney General jointly to establish a Commission to examine interoperability and other issues related to State Prescription Drug Monitoring Programs. Directs the Attorney General to: (1) update daily the Drug Enforcement Agency (DEA) database of persons registered to manufacture, distribute, or dispense a controlled substance under the Controlled Substances Act to reflect any changes in the information in the Death Master File of the Social Security Administration; (2) agree with the Commissioner of Social Security to obtain death information in order to update such database; (3) establish procedures and rules to restrict access to the database to deter its fraudulent use; and (4) establish procedures and rules to review and investigate pharmacy claims under Medicare part D that contain a registration number not assigned to a practitioner by the Attorney General under the Controlled Substances Act. Amends SSA title XVIII to require certain annual reports to describe the types and financial costs to the Medicare program of improper payment vulnerabilities identified by Recovery Audit Contractors (RACs). Requires the Secretary of HHS to develop a plan to revise the beneficiary incentive program under the Health Instance Portability and Accountability Act of 1996 (HIPAA) to encourage greater participation by individuals in reporting fraud and abuse in the Medicare program. Requires the Secretary of HHS to: (1) establish and implement procedures to eliminate the unnecessary collection, use, and display of Social Security account numbers of Medicare beneficiaries; and (2) ensure that each newly issued Medicare identification card meets specified requirements. Directs the Secretary of HHS to establish a pilot program utilizing smart card technology to evaluate its applicability to the Medicare program and whether such cards would be effective in preventing Medicare fraud. Directs the Secretary of HHS to establish policies and procedures for prepayment review, which may include pre-certification, for all claims for reimbursement for durable medical equipment (DME) at high risk of waste, fraud, and abuse, including power wheelchairs. Requires the Secretary of HHS, the HHS Inspector General, and the Attorney General to increase coordination and data sharing. Directs the Secretary of HHS to establish: (1) automated prepayment review of all Medicare claims, (2) a plan to facilitate the inclusion of states in the Medicare-Medicaid Data Match Program, and (3) a plan that allows each state Medicaid agency access to relevant data on improper or erroneous Medicare payments for items or services for dual eligible individuals. Prohibits Medicaid payments as well as payments under SSA title XXI (State Children's Health Insurance Program) (CHIP) unless a claim contains a valid beneficiary identification number and a valid National Provider Identifier. Directs the Secretary to establish Medicare administrative contractor error reduction incentives. Requires the provider enrollment process and provider screening to be separate from any contract to serve as a Medicare administrative contractor. Directs the Secretary of HHS to report to Congress on measurable metrics for improving Medicare contractor performance. Amends SSA title XI to establish penalties for the illegal distribution of a Medicare, Medicaid, or CHIP beneficiary identification number or billing privileges.

medicare medicare medicaid fast act_-_amends prescription drug benefits title xviii medicare social security act ssa direct secretary health_and_human_services hhs prohibit sponsors prescription drug plans pdps paying claims prescription drugs include valid national provider identifier drug prescriber directs secretary hhs establish procedures rules restrict access order deter fraudulent use amends ssa title xix medicaid state established meeting certain requirements decrease federal medical assistance percentage fmap respect amounts recovered paid state related overpayment fraud waste abuse allows state use amounts support state prescription drug monitoring program directs secretary hhs attorney general jointly establish commission examine interoperability issues related state prescription drug monitoring programs directs attorney general update daily dea database persons registered manufacture distribute dispense controlled substance controlled substances act reflect changes information death master file social_security_administration agree commissioner_of_social_security obtain death information order update database establish procedures rules restrict access database deter fraudulent use establish procedures rules review investigate pharmacy claims medicare contain registration number assigned practitioner attorney general controlled substances act amends ssa title xviii require certain annual reports describe types financial costs medicare program improper payment vulnerabilities identified requires secretary hhs develop plan revise beneficiary incentive program hipaa encourage greater participation individuals reporting fraud abuse medicare program requires secretary hhs establish implement procedures eliminate unnecessary collection use display social_security account numbers medicare beneficiaries ensure newly issued medicare identification card meets specified requirements directs secretary hhs establish pilot program utilizing smart card technology evaluate applicability medicare program cards effective preventing medicare fraud directs secretary hhs establish policies procedures prepayment review include pre certification claims reimbursement durable medical equipment dme high risk waste fraud abuse including power wheelchairs requires secretary hhs attorney general increase coordination data sharing directs secretary hhs establish automated prepayment review medicare claims plan facilitate inclusion states medicare-medicaid data_match_program plan allows state medicaid agency access relevant data improper erroneous medicare payments items services dual eligible individuals prohibits medicaid payments payments ssa title chip claim contains valid beneficiary identification number valid national provider identifier directs secretary establish medicare administrative contractor error reduction incentives requires provider enrollment process provider screening separate contract serve medicare administrative contractor directs secretary hhs report congress measurable metrics improving medicare contractor performance amends ssa title establish penalties illegal distribution medicare medicaid chip beneficiary identification number billing privileges


Summary:
Medicare Fraud Enforcement and Prevention Act of 2013 - 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.

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 provide for a study that analyzes the feasibility and benefits in reducing waste, fraud, and abuse of carrying out a 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.

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 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 provide study analyzes feasibility benefits reducing waste fraud abuse carrying program implements biometric technology ensure individuals entitled benefits medicare enrolled medicare physically present time place receipt certain items services payment


Summary:
Medicare Audit Improvement Act of 2013 - Directs the Secretary of Health and Human Services (HHS) to establish a process which subjects to a single, combined maximum annual limit, applied incrementally, the number of additional documentation requests made to a hospital by Medicare administrative contractors, recovery audit contractors, or Comprehensive Error Rate Testing (CERT) program contractors pursuant to prepayment and postpayment audits requiring a hospital to submit a medical record for audit purposes.

Directs the Secretary also to establish a distinct additional documentation request limit, computed according to a specified formula, for each hospital claim type for each hospital for a 45-day period in a year.

Amends title XVIII (Medicare) of the Social Security Act with respect to the Medicare Integrity Program and use of recovery audit contractors.

Requires the Secretary to ensure that recovery audit contracts include certain mandatory terms and conditions pertaining to: (1) penalties for certain compliance failures, (2) penalties for overturned appeals, (3) postpayment and prepayment audits, and (4) guidelines for prepayment review.

Directs the Secretary to publish on the Internet website of the Centers for Medicare & Medicaid Services information on recovery audit contractor performance regarding: (1) audit rates, denials, and appeals outcomes; and (2) independent performance evaluations.

Deems to be an original claim for Medicare part B (Supplementary Medical Insurance) payment a resubmitted hospital claim for Medicare part A payment for inpatient hospital services which a recovery audit contractor determines: (1) were not medically necessary and reasonable based on the site of service, but (2) would be medically necessary and reasonable in an outpatient setting of the hospital. Requires payment to be made for such a resubmitted claim for all furnished items and services for which payment may be made under Medicare part B.

Deems to be a reopened claim, for purposes of a hospital's ability to resubmit a claim for Medicare payment in timely fashion, any claim that is the subject of an audit by a recovery audit contractor or a Medicare administrative contractor.

Requires contracts for a recovery audit contractor to require that a physician review each denial of a claim for medical necessity made by an employee of the contractor who is not a physician.

Subjects to administrative and judicial review the Secretary's compliance with guidelines for reopening and revising benefit determinations.

medicare audit improvement act directs secretary health_and_human_services hhs establish process subjects single combined maximum annual limit applied incrementally number additional documentation requests hospital medicare administrative contractors recovery audit contractors comprehensive error rate testing program contractors pursuant prepayment audits requiring hospital submit medical record audit purposes directs secretary establish distinct additional documentation request limit computed according specified formula hospital claim type hospital day period year amends title xviii medicare social security act respect medicare_integrity_program use recovery audit contractors requires secretary ensure recovery audit contracts include certain mandatory terms conditions pertaining penalties certain compliance failures penalties overturned appeals prepayment audits guidelines prepayment review directs secretary publish internet website centers information recovery audit contractor performance audit rates denials appeals outcomes independent performance evaluations deems original claim medicare supplementary_medical_insurance payment resubmitted hospital claim medicare payment inpatient hospital services recovery audit contractor determines medically necessary reasonable based site service medically necessary reasonable outpatient setting hospital requires payment resubmitted claim furnished items services payment medicare deems reopened claim purposes hospital ability resubmit claim medicare payment timely fashion claim subject audit recovery audit contractor medicare administrative contractor requires contracts recovery audit contractor require physician review denial claim medical necessity employee contractor physician subjects administrative judicial review secretary compliance guidelines reopening revising benefit determinations


Summary:
Standard of Care Protection Act of 2013 - Declares that the development, recognition, or implementation of any guideline or other standard under any provision of the Patient Protection and Affordable Care Act (PPACA) or titles XVIII (Medicare) or XIX (Medicaid) of the Social Security Act shall not be construed to establish the standard of care or duty of care owed by a health care provider to a patient in any medical malpractice case.

Declares also that no provision of PPACA or amendments made by it shall be construed to preempt any state law governing medical professional liability cases.

declares development recognition implementation guideline standard provision patient_protection affordable care act ppaca titles xviii medicare xix medicaid social security act shall construed establish standard care duty care owed health care provider patient medical malpractice case declares provision ppaca amendments shall construed preempt state law governing medical professional liability cases


Summary:
Improved Health Care at Lower Cost Act of 2013 - Amends title XVIII (Medicare) and XI of the Social Security Act with respect to the prohibition against certain (potential financial conflict-of-interest) physician referrals.

Excepts from the physician self-referral prohibition any monetary incentive payments made by hospitals to physicians under certain incentive payment programs designed to align incentives among hospitals and physicians (through techniques such as product standardization, the substitution of lower cost products, and care coordination initiatives that encourage medically appropriate decreases in length of stay) to improve efficiency and decrease costs while maintaining or improving quality.

Exempts such monetary incentive payments (creates a safe harbor for them) from federal criminal antikickback and other sanctions.

amends title xviii medicare social security act respect prohibition certain potential financial conflict interest physician referrals excepts physician self referral prohibition monetary incentive payments hospitals physicians certain incentive payment programs designed align incentives hospitals physicians techniques product standardization substitution lower cost products care coordination initiatives encourage medically appropriate decreases length stay improve efficiency decrease costs maintaining improving quality exempts monetary incentive payments creates safe harbor federal criminal antikickback sanctions


Summary:
Good Samaritan Health Professionals Act of 2013 - Amends the Public Health Service Act to shield a health care professional from liability under federal or state law for harm caused by any act or omission if: (1) the professional is serving as a volunteer in response to a disaster; and (2) the act or omission occurs during the period of the disaster, in the professional's capacity as such a volunteer, and in a good faith belief that the individual being treated is in need of health care services.

Makes exceptions where: (1) the harm was caused by an act or omission constituting willful or criminal misconduct, gross negligence, reckless misconduct, or a conscious flagrant indifference to the rights or safety of the individual harmed; or (2) the professional rendered the health care services under the influence of intoxicating alcohol or an intoxicating drug.

good samaritan health professionals act amends public_health_service_act shield health care professional liability federal state law harm caused act omission professional serving volunteer response disaster act omission occurs period disaster professional capacity volunteer good faith belief individual treated need health care services makes exceptions harm caused act omission constituting willful criminal misconduct gross negligence reckless misconduct conscious flagrant indifference rights safety individual harmed professional rendered health care services influence intoxicating alcohol intoxicating drug


Summary:
State Leadership in Health Care Act - Amends the Patient Protection and Affordable Care Act (PPACA) to allow states to apply for a waiver of specified requirements under PPACA with respect to health insurance coverage within that state due to implementation of a state plan that provides comparable coverage for plan years beginning in 2015 (currently, 2017). Permits the Secretary of Health and Human Services (HHS) or the Secretary of the Treasury to deny waivers only if: (1) the state plan does not meet requirements for granting a waiver, (2) the Secretary of HHS or the Treasury notifies the state in writing of the requirements that the state plan did not meet and provides the state with information used in making such a determination, and (3) the state is given an opportunity to appeal.

Requires the Secretary of HHS or the Treasury to reconsider the determination in the event of an appeal and issue a written decision within 60 days.

state leadership health care act amends patient protection affordable care act ppaca allow states apply waiver specified requirements ppaca respect health insurance coverage state implementation state plan provides comparable coverage plan years beginning currently permits secretary health_and_human_services hhs secretary treasury deny waivers state plan meet requirements granting waiver secretary hhs treasury notifies state writing requirements state plan meet provides state information making determination state given opportunity appeal requires secretary hhs treasury reconsider determination event appeal issue written decision days


Summary:
Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013 or PRIME Act of 2013 - Amends part D (Prescription Drug Benefits) of title XVIII (Medicare) of the Social Security Act (SSA) to direct the Secretary of Health and Human Services (HHS) to prohibit sponsors of prescription drug plans (PDPs) from paying claims for prescription drugs that do not include the valid National Provider Identifier for the drug's prescriber.

Requires the Secretary's annual report to Congress on the use of recovery audit contractors under the Medicare Integrity Program to: (1) describe the types and financial cost of improper payment vulnerabilities identified by recovery audit contractors and how the Secretary is addressing them, and (2) assess the effectiveness of changes made to Medicare payment policies and procedures in order to address those vulnerabilities.

Requires the Secretary to address improper payment vulnerabilities in a timely manner, prioritized based on the risk to the Medicare program.

Authorizes the Secretary, under recovery audit contracts under both Medicare and Medicaid (SSA title XIX), to retain a certain portion of the recovered amounts for a program management account for activities addressing problems that contribute to improper payments and fraud.

Requires the Secretary, under such contracts, to retain an additional 5% of the recovered amounts to be made available to the HHS Inspector General to investigate improper payments or audit internal controls associated with Medicare or Medicaid payments.

Directs the Secretary to develop a plan to revise the incentive program under the Health Insurance Portability and Accountability Act of 1996 for the reporting of fraud and abuse to encourage greater participation by individuals reporting Medicare fraud and abuse. Requires the plan to include certain recommendations for: (1) ways to enhance rewards for individuals reporting, and (2) extention of the incentive program to the Medicaid program.

Amends SSA title XIX to cover the costs of equipment, salaries and benefits, and travel and training in appropriations for the Medicaid Integrity Program. Allows the Secretary to increase Centers for Medicare and Medicaid Services (CMS) staff whose duties consist solely of protecting the integrity of the Medicare program by a number determined necessary to carry out the Program (currently, by 100).

Directs the Secretary to provide incentives for Medicare administrative contractors to reduce the improper payment error rates in their jurisdictions.

Requires imprisonment for up to 10 years or a fine of up to $500,000 ($1 million in the case of a corporation), or both, for knowingly, intentionally, and with the intent to defraud purchasing, selling, distributing, or arranging for the purchase, sale, or distribution of a Medicare, Medicaid, or CHIP beneficiary identification number or billing privileges under SSA titles XVIII, title XIX, or title XXI (Children's Health Insurance Program).

Amends SSA title IV part D (Child Support and Establishment of Paternity) with respect to the Federal Parent Locator Service to give the CMS Administrator access to information in the National Directory of New Hires to determine the eligibility of an applicant for, or enrollee in, the Medicare program or an applicable state health subsidy program under the Patient Protection and Affordable Care Act (PPACA).

Requires the Secretary to disclose to the HHS Inspector General information on individuals and their employers in the National Directory of New Hires if the HHS Inspector General gives the Secretary their names and Social Security account numbers. Restricts the use of such information to: (1) determining the eligibility of an applicant for, or enrollee in, the Medicare program or an applicable state health subsidy program; or (2) evaluating the integrity of such programs. Sets forth rules for the use and disclosure of such information by state agencies.

Directs the Secretary to establish a plan to encourage and facilitate the participation of states in the Medicare-Medicaid Data Match Program (Medi-Medi Program). Revises Medi-Medi Data Match Program purposes.

Amends SSA title XIX, as amended by PPACA, and XXI with respect to claims processing and detection of fraud within the Medicaid and CHIP programs.

preventing reducing improper medicare medicaid expenditures act prime act amends prescription drug benefits title xviii medicare social security act ssa direct secretary health_and_human_services hhs prohibit sponsors prescription drug plans pdps paying claims prescription drugs include valid national provider identifier drug prescriber requires secretary annual report congress use recovery audit contractors medicare_integrity_program describe types financial cost improper payment vulnerabilities identified recovery audit contractors secretary addressing assess effectiveness changes medicare payment policies procedures order address vulnerabilities requires secretary address improper payment vulnerabilities timely manner prioritized based risk medicare program authorizes secretary recovery audit contracts medicare medicaid ssa title xix retain certain portion recovered amounts program management account activities addressing problems contribute improper payments fraud requires secretary contracts retain additional recovered amounts available investigate improper payments audit internal controls associated medicare medicaid payments directs secretary develop plan revise incentive program health_insurance_portability_and_accountability_act reporting fraud abuse encourage greater participation individuals reporting medicare fraud abuse requires plan include certain recommendations ways enhance rewards individuals reporting incentive program medicaid program amends ssa title xix cover costs equipment salaries benefits travel training appropriations medicaid_integrity_program allows secretary increase centers medicare medicaid_services cms staff duties consist solely protecting integrity medicare program number determined necessary carry program currently directs secretary provide incentives medicare administrative contractors reduce improper payment error rates jurisdictions requires imprisonment years fine million case corporation knowingly intentionally intent defraud purchasing selling distributing arranging purchase sale distribution medicare medicaid chip beneficiary identification number billing privileges ssa titles xviii title xix title amends ssa title child support establishment paternity respect federal_parent_locator_service access information national_directory_of_new_hires determine eligibility applicant enrollee medicare program applicable state health subsidy program patient_protection affordable care act ppaca requires secretary disclose hhs_inspector general information individuals employers national_directory_of_new_hires hhs_inspector general gives secretary names social_security account numbers restricts use information determining eligibility applicant enrollee medicare program applicable state health subsidy program evaluating integrity programs sets forth rules use disclosure information state agencies directs secretary establish plan encourage facilitate participation states medicare-medicaid data_match_program medi-medi_program data match program purposes amends ssa title xix amended ppaca xxi respect claims processing detection fraud medicaid chip programs


Summary:
Family Health Care Accessibility Act of 2013 - 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; and (2) the health care practitioner does not receive any compensation for providing the service, except repayment for reasonable expenses.

Considers an entity as sponsoring the health care practitioner if the entity submits an application to the Secretary of Health and Human Services (HHS), and 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 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 annually. 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, 2014.

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 health care practitioner receive compensation providing service repayment reasonable expenses considers entity sponsoring health care practitioner entity submits application secretary health_and_human_services hhs secretary determines health care practitioner deemed employee public_health_service requires attorney general submit congress estimate claims related fees expenses witnesses reason actions omissions health professional volunteers paid pursuant act annually requires secretary transfer estimated claims fund appropriate accounts treasury subject extent amounts fund makes act effective october


Summary:
Medicare Abuse Prevention Act of 2013 or MAP Act of 2013 - 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.

Directs the Secretary of Health and Human Services to submit to Congress annual fraud reports with respect to Medicare, SSA title XIX (Medicaid), and SSA title XXI (Children's Health Insurance) (CHIP).

Amends the Small Business Jobs Act to exempt from disclosure under the Freedom of Information Act the algorithms used in predictive modeling and other analytics technology to identify and prevent waste, fraud, and abuse in the Medicare fee-for-service program.

Requires valid National Provider Identifiers for prescribers on pharmacy claims for covered Medicare part D prescription drugs.

Requires a prescription drug plan (PDP) sponsor identifying a claim for reimbursement for a drug prescribed by an individual without a valid National Provider Identifier to report to the HHS Inspector General any relevant information on such a prescriber, including any invalid national provider identifiers being used to submit such claims and related records. Requires the Inspector General of HHS to provide such information to appropriate law enforcement agencies.

Directs the Secretary of HHS to establish procedures and rules to restrict access to the National Provider Identifier Registry in order to deter the fraudulent use of National Provider Identifiers.

Decreases by 10% per quarter the federal medical assistance percentage (FMAP) for a state if: (1) it is receiving a grant for a state controlled substance monitoring program through which it identifies fraud, waste, or abuse in connection with the provision of prescription drug coverage under the state Medicaid plan; and (2) the state or a political subdivision is reimbursed by a third party for expenditures related to such fraud, waste, or abuse, or for a recovered amount.

Directs the Secretary of HHS to establish procedures to eliminate the unnecessary collection, use, and display of Social Security account numbers of Medicare beneficiaries.

Requires the Secretary of HHS to ensure that each newly issued Medicare identification card does not display or electronically store, in an unencrypted format, a Medicare beneficiary's Social Security account number, unless the beneficiary's health insurance claim number is the beneficiary's or spouse's Social Security number, and the risk of fraudulent use of such numbers is not unacceptably high.

Requires the Secretary of HHS to prohibit the display of a Medicare beneficiary's Social Security account number in any written or electronic communication to the beneficiary unless its inclusion is essential for the operation of the Medicare program.

Directs the Secretary of HHS to establish a pilot program to evaluate the applicability of smart card technology to the Medicare program, and whether such cards would be effective in preventing Medicare fraud.

Prohibits payment for an item or service under Medicaid or CHIP unless the claim contains: (1) a valid beneficiary identification number corresponding to an individual enrolled under the state plan or an applicable waiver; and (2) a valid provider identifier corresponding to a provider eligible to receive payment for furnishing such item or service.

medicare abuse prevention act map act amends title social security act ssa increase civil money penalties criminal fines prison sentences fraud abuse ssa title xviii medicare program directs secretary health_and_human_services submit congress annual fraud reports respect medicare ssa title xix medicaid ssa title chip amends small_business_jobs_act exempt disclosure freedom information act predictive modeling analytics technology identify prevent waste fraud abuse medicare fee service program requires valid national provider identifiers prescribers pharmacy claims covered medicare prescription drugs requires prescription drug plan pdp sponsor identifying claim reimbursement drug prescribed individual valid national provider identifier report hhs_inspector general relevant information prescriber including invalid national provider identifiers submit claims related records requires inspector general hhs provide information appropriate law enforcement agencies directs secretary hhs establish procedures rules restrict access order deter fraudulent use decreases quarter federal medical assistance percentage fmap state receiving grant state controlled substance monitoring program identifies fraud waste abuse connection provision prescription drug coverage state medicaid plan state political subdivision reimbursed party expenditures related fraud waste abuse recovered directs secretary hhs establish procedures eliminate unnecessary collection use display social_security account numbers medicare beneficiaries requires secretary hhs ensure newly issued medicare identification card display electronically store unencrypted format medicare beneficiary social_security account number beneficiary health insurance claim number beneficiary spouse social_security number risk fraudulent use numbers high requires secretary hhs prohibit display medicare beneficiary social_security account number written electronic communication beneficiary inclusion essential operation medicare program directs secretary hhs establish pilot program evaluate applicability smart card technology medicare program cards effective preventing medicare fraud prohibits payment item service medicaid chip claim contains valid beneficiary identification number corresponding individual enrolled state plan applicable waiver valid provider identifier corresponding provider eligible receive payment furnishing item service


Summary: Medicare Data Access for Transparency and Accountability Act - Amends title XI of the Social Security Act (SSA) to direct the Secretary of Health and Human Services (HHS) to make available to the public HHS claims and payment data related to SSA title XVIII (Medicare), including data on payments made to any service provider or supplier.

title social security act ssa direct secretary health_and_human_services hhs available public hhs claims payment data related ssa title xviii medicare including data payments service provider supplier