Sec. 3. Annual Medicare, Medicaid, and CHIP fraud reports
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By not later than July 1, 2014, and each subsequent year, the Secretary of Health and Human Services shall submit to the Committees on Ways and Means and Energy and Commerce of the House of Representatives and the Committee on Finance of the Senate a report that contains the following: The amount, as estimated by the Secretary— of total suspected fraud committed against the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, and the Children’s Health Insurance Program under title XXI of such Act; and the amount of such suspected fraud that is committed by employees of the Department of Health and Human Services who have access to data from any of the programs under subparagraph
(A). Information on implementation of the data access requirement under section 1128J(a)(2) of the Social Security Act (42 U.S.C. 1320a–7k(a)(2)). The Secretary shall base the estimate of suspected fraud under subsection (a)(1)(A) on an audit of a random sample of at least 10,000 claims for payment made under the programs under title XVIII, XIX, or XXI of the Social Security Act. For purposes of conducting the audits under paragraph
(1), the Secretary may— request that a health care provider or supplier submit documentation relating to the claim being audited and review such documentation; conduct unannounced onsite visits; and interview patients. Not later than 30 days after receiving a request for documentation under paragraph (2)(A) , the health care provider or supplier shall provide to the Secretary all requested documentation related to such claim. The Secretary shall base the estimate of suspected fraud committed by employees of the Department of Health and Human Services under subsection (a)(1)(B) on an internal audit. In this section, the term fraud has the meaning given such term in section 455.2 of title 42, Code of Federal Regulations.
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- 42 USC 1320a–7k(a)(2)
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Sec. 3
Annual Medicare, Medicaid, and CHIP fraud reports
Cite42 USC 1320a–7k(a)(2)
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