To amend title 28, United States Code, to authorize the appointment of additional bankruptcy judges for the judicial district of Maryland. (Introduced in Senate) To amend title 28, United States Code, to authorize the appointment
of additional bankruptcy judges for the judicial district of Maryland.
(Introduced in Senate)
S 454 IS
106th CONGRESS
1st Session
S. 454
To amend title 28, United States Code, to authorize the
appointment of additional bankruptcy judges for the judicial district of
Maryland.
IN THE SENATE OF THE UNITED STATES
February 24, 1999
Mr. SARBANES (for himself and Ms. MIKULSKI) introduced the following
bill; which was read twice and referred to the Committee on the
Judiciary
A BILL
To amend title 28, United States Code, to authorize the
appointment of additional bankruptcy judges for the judicial district of
Maryland.
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. BANKRUPTCY JUDGESHIPS.
In section 152(a)(2) of title 28, United States Code, in the
item relating to the judicial district of Maryland, strike `4' and
insert `8'.
To combat waste, fraud, and abuse in payments for home health services provided under the Medicare program, and to improve the quality of those home health services. Home Health Integrity Preservation Act of 1999 (Introduced in
Senate)
S 255 IS
106th CONGRESS
1st Session
S. 255
To combat waste, fraud, and abuse in payments for home health
services provided under the Medicare program, and to improve the quality
of those home health services.
IN THE SENATE OF THE UNITED STATES
January 20, 1999
Mr. GRASSLEY (for himself and Mr. BREAUX) introduced the following
bill; which was read twice and referred to the Committee on Finance
A BILL
To combat waste, fraud, and abuse in payments for home health
services provided under the Medicare program, and to improve the quality
of those home health services.
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE- This Act may be cited as the `Home Health
Integrity Preservation Act of 1999'.
(b) TABLE OF CONTENTS- The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Additional conditions of participation for home
health agencies.
Sec. 3. Surveyor training in reimbursement and coverage
policies.
Sec. 4. Surveys and reviews.
Sec. 5. Prior patient load.
Sec. 6. Establishment of standards and procedures to improve
quality of services.
Sec. 7. Notification of availability of a home health
agency's most recent survey as part of discharge planning
process.
Sec. 8. Home health integrity task force.
Sec. 9. Application of certain provisions of the bankruptcy
code.
Sec. 10. Study and report to Congress.
Sec. 11. Effective date.
SEC. 2. ADDITIONAL CONDITIONS OF PARTICIPATION FOR HOME HEALTH
AGENCIES.
(a) QUALIFICATIONS OF MANAGING EMPLOYEES- Section 1891(a) of
the Social Security Act (42 U.S.C. 1395bbb(a)) is amended by adding at
the end the following:
`(7) The agency shall have--
`(A) sufficient knowledge, as attested by the managing
employees (as defined in section 1126(b)) of the agency (pursuant to
subsection (c)(2)(C)(iv)(II)) using standards established by the
Secretary, of the requirements for reimbursement under this title,
coverage criteria and claims procedures, and the civil and criminal
penalties for noncompliance with such requirements; and
`(B) managing employees with sufficient prior education
or work experience, according to standards determined by the Secretary,
in the delivery of health care.'.
(b) COMPLIANCE PROGRAM- Section 1891(a) of the Social Security
Act (42 U.S.C. 1395bbb(a)) (as amended by subsection (a)) is amended by
adding at the end the following:
`(8) The agency has developed and implemented a fraud and
abuse compliance program.'.
(c) AVAILABILITY OF SURVEY- Section 1891(a) of the Social
Security Act (42 U.S.C. 1395bbb(a)) (as amended by subsection (b)) is
amended by adding at the end the following:
`(9) The agency, before the agency provides any home health
services to a beneficiary, makes available to the beneficiary or the
representative of the beneficiary a summary of the pertinent findings
(including a list of any deficiencies) of the most recent survey of the
agency relating to the compliance of such agency. Such summary shall be
provided in a standardized format and may, at the discretion of the
Secretary, also include other information regarding the agency's
operations that are of potential interest to beneficiaries, such as the
number of patients served by the agency.'.
(d) NOTICE OF NEW HOME HEALTH SERVICE, NEW BRANCH OFFICE, AND
NEW JOINT VENTURE- Section 1891(a)(2) of the Social Security Act (42
U.S.C. 1395bbb(a)(2)) is amended to read as follows:
`(2)(A) The agency notifies the agency's fiscal
intermediary and the State entity responsible for the licensing or
certification of the agency--
`(i) of a change in the persons with an ownership or
control interest (as defined in section 1124(a)(3)) in the
agency,
`(ii) of a change in the persons who are officers,
directors, agents, or managing employees (as defined in section 1126(b))
of the agency,
`(iii) of a change in the corporation, association, or
other company responsible for the management of the
agency,
`(iv) that the agency is providing a category of
skilled service that it was not providing at the time of the agency's
most recent standard survey,
`(v) that the agency is operating a new branch office
that was not in operation at the time of the agency's most recent
standard survey, and
`(vi) that the agency is involved in a new joint
venture with other health care providers or other business
entities.
`(B) The notice required under subparagraph (A) shall be
provided--
`(i) for a change described in clauses (i), (ii), and
(iii) of such subparagraph, within 30 calendar days of the time of the
change and shall include the identity of each new person or company
described in the previous sentence,
`(ii) for a change described in clause (iv) of such
subparagraph, within 30 calendar days of the time the agency begins
providing the new service and shall include a description of the
service,
`(iii) for a change described in clause (v) of such
subparagraph, within 30 calendar days of the time the new branch office
begins operations and shall include the location of the office and a
description of the services that are being provided at the office,
and
`(iv) for a change described in clause (vi) of such
subparagraph, within 30 calendar days of the time the agency enters into
the joint venture agreement and shall include a description of the joint
venture and the participants in the joint venture.'.
SEC. 3. SURVEYOR TRAINING IN REIMBURSEMENT AND COVERAGE
POLICIES.
Section 1891(d)(3) of the Social Security Act (42 U.S.C.
1395bbb(d)(3)) is amended--
(1) by striking `relating to the performance' and inserting
`relating to--
`(A) the performance';
(2) by striking the period at the end and inserting `;
and'; and
(3) by adding at the end the following:
`(B) requirements for reimbursement and coverage of
services under this title.'.
SEC. 4. SURVEYS AND REVIEWS.
(a) ADDITIONAL REQUIREMENTS FOR SURVEY- Section 1891(c)(2)(C)
of the Social Security Act (42 U.S.C. 1395bbb(c)(2)(C)) is
amended--
(1) in clause (i)(I)--
(A) by striking `purpose of evaluating' and inserting
`purpose of--
`(aa) evaluating'; and
(B) by adding at the end the following:
`(bb) evaluating whether the individuals are
homebound for purposes of qualifying for receipt of benefits for home
health services under this title; and';
(2) in clause (ii), by striking `and' at the end;
(3) in clause (iii), by striking the period at the end and
inserting `; and'; and
(4) by adding at the end the following:
`(iv) shall include--
`(I) an assessment of whether the agency is in
compliance with all of the conditions of participation and requirements
specified in or pursuant to section 1861(o), this section, and this
title;
`(II) an assessment that the managing employees (as
defined in section 1126(b)) of the agency have attested in writing to
having sufficient knowledge, as determined by the Secretary, of the
requirements for reimbursement under this title, coverage criteria and
claims procedures, and the civil and criminal penalties for
noncompliance with such requirements; and
`(III) a review of the services provided by
subcontractors of the agency to ensure that such services are being
provided in a manner consistent with the requirements of this
title.'.
(b) ADDITIONAL EVENTS TRIGGERING A SURVEY- Section
1891(c)(2)(B) of the Social Security Act (42 U.S.C. 1395bbb(c)(2)(B)) is
amended--
(1) by striking `and' at the end of clause (i);
(2) by striking the period at the end of clause (ii) and
inserting a comma; and
(3) by adding at the end the following:
`(iii) shall be conducted not less than annually
for the first 2 years after the initial standard survey of the
agency,
`(iv) after the agency's first 2 years of
participation under this title, shall be conducted within 90 calendar
days of the date that the agency notifies the Secretary that it is
providing a category of skilled service that the agency was not
providing at the time of the agency's most recent standard
survey,
`(v) if the agency is operating a new branch office
that was not in operation at the time of the agency's most recent
standard survey, shall be conducted within the 12-month period following
the date that the new branch office began operations to ensure that such
office is providing quality care and that it is appropriately classified
as a branch office, and shall include direct scrutiny of the operations
of the branch office, and
`(vi) shall be conducted on randomly selected
agencies on an occasional basis, with the number of such surveys to be
determined by the Secretary.'.
(c) REVIEW BY FISCAL INTERMEDIARY- Section 1816 of the Social
Security Act (42 U.S.C. 1395h) is amended by adding at the end the
following:
`(m) An agreement with an agency or organization under this
section shall require that the agency or organization conduct a review
of the overall business structure of a home health agency submitting a
claim for reimbursement for home health services, including any related
organizations of the home health agency.'.
SEC. 5. PRIOR PATIENT LOAD.
Section 1891 of the Social Security Act (42 U.S.C. 1395bbb) is
amended by adding at the end the following:
`(h) PRIOR PATIENT LOAD-
`(1) IN GENERAL- The Secretary shall not enter into an
agreement for the first time with a home health agency to provide items
and services under this title unless the Secretary determines that,
before the date the agreement is entered into, the agency--
`(A) had been in operation for at least 60 calendar
days; and
`(B) had at least 10 patients during that period of
prior operation.
`(2) EXCEPTIONS-
`(A) BENEFICIARY ACCESS- If the Secretary determines
appropriate, the Secretary may waive the requirements of paragraph (1)
in order to establish or maintain beneficiary access to home health
services in an area.
`(B) CHANGE OF OWNERSHIP- The requirements of paragraph
(1) shall not apply to a home health agency at the time of a change in
ownership of such agency.'.
SEC. 6. ESTABLISHMENT OF STANDARDS AND PROCEDURES TO IMPROVE
QUALITY OF SERVICES.
(a) IN GENERAL- Section 1891 of the Social Security Act (42
U.S.C. 1395bbb) (as amended by section 5) is amended by adding at the
end the following:
`(i) ESTABLISHMENT OF STANDARDS AND PROCEDURES-
`(1) SCREENING OF EMPLOYEES- The Secretary shall establish
procedures to improve the background screening performed by a home
health agency on individuals that the agency is considering hiring as
home health aides (as defined in subsection
(a)(3)(E)) and licensed health professionals (as defined in
subsection (a)(3)(F)).
`(2) COST REPORTS- The Secretary shall establish additional
procedures regarding the requirement for attestation of cost reports to
ensure greater accountability on the part of a home health agency and
its managing employees (as defined in section 1126(b)) for the accuracy
of the information provided to the Secretary in any such cost
reports.
`(3) MONITORING AGENCY AFTER EXTENDED SURVEY- The Secretary
shall establish procedures to ensure that a home health agency that is
subject to an extended (or partial extended) survey is closely monitored
from the period immediately following the extended survey through the
agency's subsequent standard survey to ensure that the agency is in
compliance with all the conditions of participation and requirements
specified in or pursuant to section 1861(o), this section, and this
title.
`(4) ADDITIONAL AUDITS-
`(A) IN GENERAL-
`(i) STANDARDS- The Secretary shall establish
objective standards regarding the determination of--
`(I) whether an agency is a home health agency
described in subparagraph (B); and
`(II) the circumstances that trigger an audit
for a home health agency described in subparagraph (B), and the content
of such an audit.
`(ii) INFORMATION- In establishing standards under
clause (i), the Secretary shall ensure that the individuals performing
the audits under this section are provided with the necessary
information, including information from intermediaries, carriers, and
law enforcement sources, in order to determine if a particular home
health agency is an agency described in subparagraph (B) and whether the
circumstances triggering an audit for such an agency has
occurred.
`(B) AGENCY DESCRIBED- A home health agency is
described in this subparagraph if it is an agency that
has--
`(i) experienced unusually rapid growth as compared
to other home health agencies in the area and in the
country;
`(ii) had unusually high utilization patterns as
compared to other home health agencies in the area and in the
country;
`(iii) unusually high costs per patient as compared
to other home health agencies in the area and in the
country;
`(iv) unusually high levels of overpayment or
coverage denials as compared to other home health agencies in the area
and in the country; or
`(v) operations that otherwise raise concerns such
that the Secretary determines that an audit is
appropriate.
`(5) BRANCH OFFICES-
`(A) SURVEYS- The Secretary shall establish standards
for periodic surveys of branch offices of a home health agency in order
to assess whether the branch offices meet the Secretary's national
criteria for branch office designation and for quality of care. Such
surveys shall include home visits to beneficiaries served by the branch
office (but only with the consent of the beneficiary).
`(B) UNIFORM NATIONAL DEFINITION- The Secretary shall
establish a uniform national definition of a branch office of a home
health agency.
`(6) CERTAIN QUALIFICATIONS OF MANAGING EMPLOYEES- The
Secretary shall establish standards regarding the knowledge and prior
education or work experience that a managing employee (as defined in
section 1126(b)) of an agency must possess in order to comply with the
requirements described in subsection (a)(7).
`(7) CLAIMS PROCESSING-
`(A) IN GENERAL- The Secretary shall establish
standards to improve and strengthen the procedures by which claims for
reimbursement by home health agencies are identified as being
fraudulent, wasteful, or abusive.
`(B) PROCEDURES- The standards established by the
Secretary pursuant to subparagraph (A) shall include, to the extent
practicable, standards for a minimum number of--
`(i) intensive focused medical reviews of the
services provided to beneficiaries by an agency;
`(ii) interviews with beneficiaries, employees of
the agency, and other individuals providing services on behalf of the
agency; and
`(iii) random spot checks of visits to a
beneficiary's home by employees of the agency (but only with the consent
of the beneficiary).
`(C) REPORT TO CONGRESS- Not later than 90 days after
the date of enactment of the Home Health Integrity Preservation Act of
1999, the Secretary shall submit a report to Congress containing a
detailed description of--
`(i) the current levels of activity by the
Secretary with regard to the reviews, interviews, and spot checks
described in subparagraph (B); and
`(ii) the Secretary's plans to increase those
levels pursuant to the procedures described in subparagraphs (A) and
(B).
`(8) EXPANSION OF FINANCIAL STATEMENT- The Secretary shall
establish procedures to expand the financial statement audit process to
include compliance and integrity reviews.'.
(b) EFFECTIVE DATE- By not later than 180 calendar days after
the date of enactment of this Act, the Secretary shall establish the
standards and procedures described in paragraphs (1) through (8) of
section 1891(i) of the Social Security Act (42 U.S.C. 1395bbb(i)) (as
added by subsection (a)) by regulation or other sufficient means.
SEC. 7. NOTIFICATION OF AVAILABILITY OF A HOME HEALTH AGENCY'S
MOST RECENT SURVEY AS PART OF DISCHARGE PLANNING PROCESS.
Section 1861(ee)(2)(D) of the Social Security Act (42 U.S.C.
1395x(ee)(2)(D)) (as amended by section 4321(a) of the Balanced Budget
Act of 1997) is amended--
(1) by striking `including the availability' and inserting
`including--
`(i) the availability'; and
(2) by inserting before the period the following: `;
and
`(ii) the availability of (and procedures for obtaining
from a home health agency) a summary document described in section
1891(a)(9)'.
SEC. 8. HOME HEALTH INTEGRITY TASK FORCE.
(a) ESTABLISHMENT- The Secretary of Health and Human Services
(in this section referred to as the `Secretary') shall establish within
the Office of the Inspector General of the Department of Health and
Human Services
a home health integrity task force (in this section referred to as
the `Task Force').
(b) DIRECTOR- The Inspector General of the Department of Health
and Human Services shall appoint the Director of the Task Force.
(c) DUTIES- The Task Force shall target, investigate, and
pursue any available civil or criminal actions against individuals who
organize, direct, finance, or are otherwise engaged in fraud in the
provision of home health services (as defined in section 1861(m) of the
Social Security Act (42 U.S.C. 1395x(m))) under the medicare program
under such Act.
To amend title 11, United States Code, to protect certain charitable contributions, and for other purposes. Religious Liberty and Charitable Donation Protection Act of 1998
(Engrossed as Agreed to or Passed by Senate)
S 1244 ES
105th CONGRESS
2d Session
S. 1244
AN ACT
To amend title 11, United States Code, to protect certain
charitable contributions, and for other purposes.
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Religious Liberty and Charitable
Donation Protection Act of 1998'.
SEC. 2. DEFINITIONS.
Section 548(d) of title 11, United States Code, is amended by
adding at the end the following:
`(3) In this section, the term `charitable contribution' means
a charitable contribution, as that term is defined in section 170(c) of
the Internal Revenue Code of 1986, if that contribution--
`(A) is made by a natural person; and
`(B) consists of--
`(i) a financial instrument (as that term is defined in
section 731(c)(2)(C) of the Internal Revenue Code of 1986);
or
`(ii) cash.
`(4) In this section, the term `qualified religious or
charitable entity or organization' means--
`(A) an entity described in section 170(c)(1) of the
Internal Revenue Code of 1986; or
`(B) an entity or organization described in section
170(c)(2) of the Internal Revenue Code of 1986.'.
SEC. 3. TREATMENT OF PRE-PETITION QUALIFIED CHARITABLE
CONTRIBUTIONS.
(a) IN GENERAL- Section 548(a) of title 11, United States Code,
is amended--
(1) by inserting `(1)' after `(a)';
(2) by striking `(1) made' and inserting `(A)
made';
(3) by striking `(2)(A)' and inserting `(B)(i);
(4) by striking `(B)(i)' and inserting `(ii)(I)';
(5) by striking `(ii) was' and inserting `(II)
was';
(6) by striking `(iii)' and inserting `(III)';
and
(7) by adding at the end the following:
`(2) A transfer of a charitable contribution to a qualified
religious or charitable entity or organization shall not be considered
to be a transfer covered under paragraph (1)(B) in any case in
which--
`(A) the amount of that contribution does not exceed 15
percent of the gross annual income of the debtor for the year in which
the transfer of the contribution is made; or
`(B) the contribution made by a debtor exceeded the
percentage amount of gross annual income specified in subparagraph (A),
if the transfer was consistent with the practices of the debtor in
making charitable contributions.'.
(b) TRUSTEE AS LIEN CREDITOR AND AS SUCCESSOR TO CERTAIN
CREDITORS AND PURCHASERS- Section 544(b) of title 11, United States
Code, is amended--
(1) by striking `(b) The trustee' and inserting `(b)(1)
Except as provided in paragraph (2), the trustee'; and
(2) by adding at the end the following:
`(2) Paragraph (1) shall not apply to a transfer of a
charitable contribution (as that term is defined in section 548(d)(3))
that is not covered under section 548(a)(1)(B), by reason of section
548(a)(2). Any claim by any person to recover a transferred contribution
described in the preceding sentence under Federal or State law in a
Federal or State court shall be preempted by the commencement of the
case.'.
(c) CONFORMING AMENDMENTS- Section 546 of title 11, United
States Code, is amended--
(1) in subsection (e)--
(A) by striking `548(a)(2)' and inserting
`548(a)(1)(B)'; and
(B) by striking `548(a)(1)' and inserting
`548(a)(1)(A)';
(2) in subsection (f)--
(A) by striking `548(a)(2)' and inserting
`548(a)(1)(B)'; and
(B) by striking `548(a)(1)' and inserting
`548(a)(1)(A)'; and
(3) in subsection (g)--
(A) by striking `section 548(a)(1)' each place it
appears and inserting `section 548(a)(1)(A)'; and
(B) by striking `548(a)(2)' and inserting
`548(a)(1)(B)'.
SEC. 4. TREATMENT OF POST-PETITION CHARITABLE CONTRIBUTIONS.
(a) CONFIRMATION OF PLAN- Section 1325(b)(2)(A) of title 11,
United States Code, is amended by inserting before the semicolon the
following: `, including charitable contributions (that meet the
definition of `charitable contribution' under section 548(d)(3)) to a
qualified religious or charitable entity or organization (as that term
is defined in section 548(d)(4)) in an amount not to exceed 15 percent
of the gross income of the debtor for the year in which the
contributions are made'.
(b) DISMISSAL- Section 707(b) of title 11, United States Code,
is amended by adding at the end the following: `In making a
determination whether to dismiss a case under this section, the court
may not take into consideration whether a debtor has made, or continues
to make, charitable contributions (that meet the definition of
`charitable contribution' under section 548(d)(3)) to any qualified
religious or charitable entity or organization (as that term is defined
in section 548(d)(4)).'.
SEC. 5. APPLICABILITY.
This Act and the amendments made by this Act shall apply to any
case brought under an applicable provision of title 11, United States
Code, that is pending or commenced on or after the date of enactment of
this Act.
SEC. 6. RULE OF CONSTRUCTION.
Nothing in the amendments made by this Act is intended to limit
the applicability of the Religious Freedom Restoration Act of 1993 (42
U.S.C. 2002bb et seq.).
Passed the Senate May 13, 1998.
Attest:
Secretary.
105th CONGRESS
2d Session
S. 1244
AN ACT
To amend title 11, United States Code, to protect certain charitable
contributions, and for other purposes.
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To combat waste, fraud, and abuse in payments for home health services provided under the medicare program, and to improve the quality of those home health services.
