HB 2351 — An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in fraud and abuse control, further providing for definitions and for provider prohibited acts, criminal penalties and civil remedies.

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3508 PRINTER'STHE NO.GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.

3912 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.

MILLER, RADER,RADER ROWE AND NELSON,ROWE, APRIL 3, 2020 ASREFERRED REPORTEDTO FROM COMMITTEE ON HUMAN SERVICES, HOUSEAPRIL OF3, REPRESENTATIVES, AS AMENDED, JUNE 9, 2020 AN ACT Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An act to consolidate, editorially revise, and codify the public welfare laws of the Commonwealth," in fraud and abuse control, further providing for definitions and for provider prohibited acts, criminal penalties and civil remedies.

(2) Solicit or receive or to offer or pay any remuneration, including any kickback, bribe or rebate, directly or indirectly, in cash or in kind from or to any person in connection with the 20200HB2351PN3912 - 2 - furnishing of services or merchandise for which payment may be 20200HB2351PN3508 - 2 - in whole or in part under the medical assistance program or in connection with referring an individual to a person for the furnishing or arranging for the furnishing of any services or merchandise for which payment may be made in whole or in part under the medical assistance program.

20200HB2351PN3912 - 3 - (9) Submit or cause to be submitted a claim for a service or 20200HB2351PN3508 - 3 - item which was not rendered by the provider.

(b) (1) [A person who violates any provision of subsection (a), excepting subsection (a)(11), is guilty of a felony of the third degree for each such violation with a maximum penalty of 20200HB2351PN3912 - 4 - fifteen thousand dollars ($15,000) and seven years imprisonment.

20200HB2351PN3508 - 4 - A violation of subsection (a) shall be deemed to continue so long as the course of conduct or the defendant's complicity therein continues;

(b.1) (1) In addition to the penalties provided under 20200HB2351PN3912 - 5 - subsection (b), the trial court shall order any person convicted 20200HB2351PN3508 - 5 - under subsection (a):

"PERSON."(b.2) THE TERM DOES NOT INCLUDE A RECIPIENTviolation RECEIVINGof <--subsection 20200HB2351PN3912(a) -shall 6be -deemed PUBLICto SUPPORTcontinue SERVICESso UNLESSlong THEas RECIPIENTthe KNOWINGLYcourse ORof INTENTIONALLYconduct COMMITSor Athe PROHIBITEDperson's ACT20200HB2351PN3508 UNDER- SUBSECTION6 (A)- ANDcomplicity BENEFITSin FINANCIALLYthe FROMcourse THEof VIOLATION.conduct continues.

(b.2) A violation of subsection (a) shall be deemed to continue so long as the course of conduct or the person's complicity in the course of conduct continues.

(3) [Notice of any action taken by the department against a 20200HB2351PN3912 - 7 - provider pursuant to clauses (1) and (2) will be forwarded by the department to the Medicaid Fraud Control Unit of the Department of Justice and to the appropriate licensing board of the Department of State for appropriate action, if any.

In addition, the department will forward to the Medicaid Fraud 20200HB2351PN3508 - 7 - Control Unit of the Department of Justice and the appropriate Pennsylvania licensing board of the Department of State any cases of suspected provider fraud.] The department shall forward notice of any action taken by the department against a provider under this section to the Medicaid Fraud Control Unit of the Office of Attorney General and to the appropriate licensing board of the Department of State for appropriate action.

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