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42 U.S.C. § 1395b–5Beneficiary incentive programs

submitted 30 years ago by Pub. L. 104-191 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 348 words · no verdicts yet

in plain englishAI-generated · not legal advice

Subsection (a) is repealed. The remaining provisions create programs for reporting Medicare fraud and suggesting efficiency improvements, with possible payments to qualifying informants.

(a) Repealed. Pub. L. 105–33, title IV, § 4311(b)(2) , Aug. 5, 1997 , 111 Stat. 386 (b) Program to collect information on fraud and abuse (1) Establishment of program Not later than 3 months after August 21, 1996 , the Secretary must establish a program under which the Secretary must encourage individuals to report to the Secretary information on individuals and entities who are engaging in or who have engaged in acts or omissions which constitute grounds for the imposition of a sanction under section 1320a–7, 1320a–7a, or 1320a–7b of this title, or who have otherwise engaged in fraud and abuse against the Medicare program under this subchapter for which there is a sanction provided under law. The program must discourage provision of, and not consider, information which is frivolous or otherwise not relevant or material to the imposition of such a sanction. (2) Payment of portion of amounts collected If an individual reports information to the Secretary under the program established under paragraph (1) which serves as the basis for the collection by the Secretary or the Attorney General of any amount of at least $100 (other than any amount paid as a penalty under section 1320a–7b of this title ), the Secretary may pay a portion of the amount collected to the individual (under procedures similar to those applicable under section 7623 of the Internal Revenue Code of 1986 to payments to individuals providing information on violations of such Code). (c) Program to collect information on program efficiency (1) Establishment of program Not later than 3 months after August 21, 1996 , the Secretary must establish a program under which the Secretary must encourage individuals to submit to the Secretary suggestions on methods to improve the efficiency of the Medicare program. (2) Payment of portion of program savings If an individual submits a suggestion to the Secretary under the program established under paragraph (1) which is adopted by the Secretary and which results in savings to the program, the Secretary may make a payment to the individual of such amount as the Secretary considers appropriate. Terms that this section uses but does not define keep their quoted statutory meaning; this section does not define them.
the actual law source: uscode.house.gov ↗public domain
(a) Repealed. Pub. L. 105–33, title IV, § 4311(b)(2), Aug. 5, 1997, 111 Stat. 386

(b) Program to collect information on fraud and abuse
(1) Establishment of program

Not later than 3 months after August 21, 1996, the Secretary shall establish a program under which the Secretary shall encourage individuals to report to the Secretary information on individuals and entities who are engaging in or who have engaged in acts or omissions which constitute grounds for the imposition of a sanction under section 1320a–7, 1320a–7a, or 1320a–7b of this title, or who have otherwise engaged in fraud and abuse against the Medicare program under this subchapter for which there is a sanction provided under law. The program shall discourage provision of, and not consider, information which is frivolous or otherwise not relevant or material to the imposition of such a sanction.

(2) Payment of portion of amounts collected

If an individual reports information to the Secretary under the program established under paragraph (1) which serves as the basis for the collection by the Secretary or the Attorney General of any amount of at least $100 (other than any amount paid as a penalty under section 1320a–7b of this title), the Secretary may pay a portion of the amount collected to the individual (under procedures similar to those applicable under section 7623 of the Internal Revenue Code of 1986 to payments to individuals providing information on violations of such Code).

(c) Program to collect information on program efficiency
(1) Establishment of program

Not later than 3 months after August 21, 1996, the Secretary shall establish a program under which the Secretary shall encourage individuals to submit to the Secretary suggestions on methods to improve the efficiency of the Medicare program.

(2) Payment of portion of program savings

If an individual submits a suggestion to the Secretary under the program established under paragraph (1) which is adopted by the Secretary and which results in savings to the program, the Secretary may make a payment to the individual of such amount as the Secretary considers appropriate.

Source credit: (Pub. L. 104–191, title II, § 203, Aug. 21, 1996, 110 Stat. 1998; Pub. L. 105–33, title IV, § 4311(b)(2), Aug. 5, 1997, 111 Stat. 386.)

history & why it existsrecord from the source credit
  • 1996Enacted · Pub. L. 104-191 · 110 Stat. 1998
  • 1997Amended · Pub. L. 105-33 · 111 Stat. 386

A history note hasn’t been published yet. The record shows enactment by Pub. L. 104-191 on 1996-08-21.

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