United States 116th Congress Status: Died 1 D cosponsors

HR 4453 — Protecting Seniors from Health Care Fraud Act of 2019

Last action — Referred to the Subcommittee on Health.

Track this bill free

No card. One bill, free forever — alerts when it moves.

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. Died in session

This bill died with 116th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Summary

Protecting Seniors from Health Care Fraud Act of 2019 This bill directs the Office of the Inspector General of the Department of Health and Human Services and the Attorney General to report annually to Congress and the public on health care fraud that targets seniors. Specifically, the report must include (1) the 10 most prevalent health care fraud schemes targeted to seniors, (2) steps being taken to combat such schemes, and (3) policy suggestions to improve protections for seniors. The report may omit information or details that would compromise an ongoing investigation or would serve criminals rather than seniors. The report must be posted on certain agency websites and disseminated to Medicare beneficiaries, as specified.

Bill Text

Sections of law this bill changes

1 section in 1 law

From the bill's own amending language, matched to the official United States Code (current through Public Law 119-124).

Social security · 42 U.S.C. ch. 7 1 section
  • § 1395b-2 Notice of medicare benefits; medicare and medigap information Amends

    42 U.S.C. § 1395b-2

    The law today

    (a) Notice of medicare benefits The Secretary shall prepare (in consultation with groups representing the elderly and with health insurers) and provide for distribution of a notice containing— (1) a clear, simple explanation of the benefits available under this subchapter and the major categories of health care for which benefits are not available under this subchapter, (2) the limitations on payment (including deductibles and coinsurance amounts) that are imposed under this subchapter, and (3) a description of the limited benefits for long-term care services available under this subchapter and generally available under State plans approved under subchapter XIX. Such notice shall be mailed annually to individuals entitled to benefits under part A or part B of this subchapter and when an individual applies for benefits under part A or enrolls under part B. (b) Medicare and medigap information The Secretary shall provide information via a toll-free telephone number on the programs under this subchapter. The Secretary shall provide, through the toll-free telephone number 1–800–MEDICARE, for a means by which individuals seeking information about, or assistance with, such programs who phone such toll-free number are transferred (without charge) to appropriate entities for the provision of such information or assistance. Such toll-free number shall be the toll-free number listed for general information and assistance in the annual notice under subsection (a) instead of the listing of numbers of individual contractors. (c) Contents of notice The notice provided under subsection (a) shall include— (1) a statement which indicates that because errors do occur and because medicare fraud, waste, and abuse is a significant problem, beneficiaries should carefully check any explanation of benefits or itemized statement furnished pursuant to section 1395b–7 of this title for accuracy and report any errors or questionable charges by calling the toll-free phone number described in paragraph (4); (2) a statement of the beneficiary’s right to request an itemized statement for medicare items and services (as provided in section 1395b–7(b) of this title); (3) a description of the program to collect information on medicare fraud and abuse established under section 1395b–5(b) of this title; and (4) a toll-free telephone number maintained by the Inspector General in the Department of Health and Human Services for the receipt of complaints and information about waste, fraud, and abuse in the provision or billing of services under this subchapter. (d) Medicare opioid safety education The notice provided under subsection (a) shall include— (1) references to educational resources regarding opioid use and pain management; (2) a description of categories of alternative, non-opioid pain management treatments covered under this subchapter; and (3) a suggestion for the beneficiary to talk to a physician regarding opioid use and pain management.

    34 other bills also change this section · Follow it → Official text at uscode.house.gov ↗

How this bill changes current law

1 change Share ↗

Compared against current U.S. Code AI-generated reading aid — verify against the official bill.

The bill adds new requirements for distributing information on health care fraud aimed at seniors under 42 U.S.C. § 1395b-2.

  • 42 U.S.C. 1395b-2

    (e) Distribution of Additional Information on Health Care Fraud.-- (1) Annual reports on health care fraud schemes.-- (A) In general.--In connection with the Health Care Fraud and Abuse Control Program established under section 1128C, the Secretary, acting through the Office of the Inspector General of the Department of Health and Human Services, and the Attorney General, shall transmit to Congress, and make available to the public, an annual report on health care fraud schemes that are targeted to seniors and steps that are being taken to combat such schemes and to educate seniors concerning such schemes. The first such report shall be transmitted and made available not later than 2 years after the date of the enactment of this subsection. (B) Contents of reports.-- (i) In general.--Subject to clause (ii), each annual report under subparagraph (A) shall include the following information: (I) Identification of most prevalent fraud schemes.--The identification of the 10 most prevalent health care fraud schemes that are targeted to seniors and the prevalence and trends in such schemes. (II) Protection of seniors.--Actions that seniors and law enforcement and government agencies are taking and can take to combat such schemes and to protect seniors against health care fraud schemes. (III) Additional suggestions.--Policy suggestions to improve protections for seniors, including whether the additional information provided under this subsection is helping seniors in protecting them against fraud. (ii) Limitations.--The Secretary may-- (I) omit information from an annual report on fraud schemes targeting seniors if public disclosure of the information would compromise an ongoing investigation; and (II) report information on fraud schemes by categories in an annual report if a more detailed disclosure of such a scheme would educate criminals rather than seniors. (iii) Private-public partnership.--The Secretary, acting through the Office of the Inspector General of the Department of Health and Human Services and the Attorney General, may enter into an arrangement between public and private partners to develop the report that identifies the top 10 most prevalent health care fraud schemes and the associated report information. (C) Quarterly updating.--The information described in clauses (i) and (ii) of subparagraph (B) shall be updated quarterly to reflect changes in fraud schemes and methods to combat and educate seniors concerning such schemes. (D) Languages.--Such reports, as updated, shall be available in English and Spanish. (2) Dissemination of reports and top 10 list.-- (A) In general.--The Secretary shall-- (i) disseminate the reports under paragraph (1) to Medicare beneficiaries through mechanisms that reach the most Medicare beneficiaries; and (ii) provide for the mailing to each Medicare beneficiary of a list of the top 10 most prevalent health care fraud schemes. (B) Quarterly updates of top 10 list included with medicare summary notices.--The Secretary shall include an updated list of the top 10 most prevalent health care fraud schemes under paragraph (1)(C) with the quarterly Medicare summary notices mailed to Medicare beneficiaries. (C) Posting of reports and quarterly updates on websites.--The annual reports, and quarterly updates, under this subsection shall be posted on the website of the Health Care Fraud and Abuse Control Program and on other websites maintained or supported by the Secretary relating to the Medicare program, the State Health Insurance Assistance Program, and Senior Medicare Patrol of the Administration on Aging. (3) Sources of information for reports.--Information for the reports and updates under paragraph (1) shall be gathered from at least the following sources: (A) Department of health and human services.--The following sources within the Department of Health and Human Services: (i) Medicare hotlines, including 1-800- MEDICARE, 1-800-HHSTIPS, and Medicare fraud toll-free hotlines and websites (such as www.stopmedicarefraud.gov) established by the Office of the Inspector General of the Department of Health and Human Services and the Centers for Medicare & Medicaid Services. (ii) State Health Insurance Assistance Programs (SHIPs). (iii) The Administration on Community Living, including-- (I) the Senior Medicare Patrol (SMP) of the Administration on Aging; and (II) Aging and Disability Resource Centers. (iv) Medicare administrative contractors, fiscal intermediaries, and other contractors with the Centers for Medicare & Medicaid Services performing functions which may relate to fraud and abuse under the Medicare program. (v) The Indian Health Service. (B) Department of justice.--The Department of Justice, including the Federal Bureau of Investigation. (C) SSA.--The Social Security Administration. (D) FTC.--The Federal Trade Commission. (E) Optional additional sources.--At the option of the Secretary-- (i) State agencies that deal with elder abuse; and (ii) other governmental and nongovernmental entities with expertise in the protection of seniors from health care fraud as deemed appropriate.

    This addition establishes a new framework for the annual reporting and dissemination of information about health care fraud schemes targeting seniors.

Action History

  1. Referred to the Subcommittee on Health.

  2. Introduced in House

  3. Introduced in House

  4. Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

  5. Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

  6. Referred to the Subcommittee on Health.

Sponsors

Sponsorship breakdown

Export CSV (upgrade) →

1 sponsors · 0 co-sponsors · 546 not signed on

Sponsors (1)

Co-sponsors (0)

None.

Not signed on (546)

546 members have not signed on to this bill.

Show all 546 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does HR 4453 do?
Protecting Seniors from Health Care Fraud Act of 2019 This bill directs the Office of the Inspector General of the Department of Health and Human Services and the Attorney General to report annually to Congress and the public on health care fraud that targets seniors. Specifically, the report must include (1) the 10 most prevalent health care fraud schemes targeted to seniors, (2) steps being taken to combat such schemes, and (3) policy suggestions to improve protections for seniors. The report may omit information or details that would compromise an ongoing investigation or would serve criminals rather than seniors. The report must be posted on certain agency websites and disseminated to Medicare beneficiaries, as specified.
Who sponsors HR 4453?
HR 4453 is sponsored by Ruiz, Raul (Democratic).
What is the current status of HR 4453?
This bill died with 116th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track HR 4453?
Track HR 4453 free on One Click Politics — get push/email alerts when it moves.

Make your voice heard on HR 4453

Find the representatives who decide this bill and tell them where you stand — for yourself, or mobilize your whole list in one click with One Click Politics advocacy software.

Find my representatives → Run a campaign

Stay ahead of HR 4453

Last checked for changes 3 months ago · updated continuously

One Click Politics tracks every bill in Congress and all 50 states.

Track this bill →