H.R. 6332 (112th): Local Medicaid Enforcement Incentives Act of 2012

112th Congress, 2011–2013. Text as of Aug 02, 2012 (Introduced).

Status & Summary | PDF | Source: GPO

I

112th CONGRESS

2d Session

H. R. 6332

IN THE HOUSE OF REPRESENTATIVES

August 2, 2012

introduced the following bill; which was referred to the Committee on Energy and Commerce

A BILL

To establish a grant program to provide States with funds to detect fraud, waste, and abuse in the State Medicaid programs under title XIX of the Social Security Act and to recover improper payments resulting from such fraud, waste, and abuse.

1.

Short title

This Act may be cited as the Local Medicaid Enforcement Incentives Act of 2012.

2.

Grant program to provide States with funds to detect Medicaid fraud, waste, and abuse and recover certain improper payments

(a)

In general

The Secretary of Health and Human Services shall establish a program to award grants, subject to subsection (c), to States to establish or expand a program described in subsection (b).

(b)

Medicaid fraud control program

For purposes of subsection (a), a program described in this subsection is a program that—

(1)

is administered by a State official with responsibility for controlling provider fraud and abuse under the State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.);

(2)

detects and prevents fraud, waste, and abuse with respect to payments made under such State plan or under any waiver of such plan approved under section 1115 of the Social Security Act (42 U.S.C. 1315);

(3)

identifies and recovers overpayments to individuals or entities receiving funds under such State plan or waiver resulting from such fraud, waste, or abuse; and

(4)

shares with localities within the State that assist in the detection and prevention under paragraph (2) or the identification and recovery under paragraph (3) at least 50 percent of the State’s share of the total amount of such funds so recovered during a period as overpayments under paragraph (3) minus any amount expended during such period on administrative costs to carry out the program.

(c)

Funding

(1)

Authorization of appropriations

To carry out this section, there is authorized to be appropriated to the Secretary of Health and Human Services $100,000,000 to remain available until expended.

(2)

Limitation

Not more than 5 percent of the amount appropriated pursuant to paragraph (1) may be awarded to any State.

(d)

State defined

For purposes of this section, the term State has the meaning given such term for purposes of title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).