To amend title XI of the Social Security Act to require the Secretary to exclude certain individuals and entities who commit fraud from participation in any Federal health care program.
Summary
H.R. 6108 aims to amend Title XI of the Social Security Act, mandating the Secretary to exclude individuals and entities convicted of fraud from participating in Federal health care programs. This exclusion applies to offenses related to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct within healthcare or other government-operated programs. The bill targets both misdemeanor and felony offenses, strengthening the integrity of federal healthcare programs.
Expected Effects
The bill will likely result in stricter enforcement against fraud in federal health care programs. Individuals and entities convicted of relevant offenses will be barred from participation. This could lead to reduced fraud, potentially saving taxpayer money and improving the quality of care.
Potential Benefits
- Reduced fraud within Federal health care programs.
- Potential cost savings for taxpayers due to decreased fraudulent claims.
- Increased accountability for individuals and entities involved in health care.
- Improved integrity and public trust in government-funded health programs.
- Potentially higher quality of care as fraudulent providers are excluded.
Potential Disadvantages
- Potential for increased administrative burden in identifying and excluding fraudulent actors.
- Possible delays in health care service delivery as providers are vetted.
- Risk of erroneous exclusions, requiring due process and appeals mechanisms.
- Could disproportionately affect smaller providers or those with limited resources to navigate complex regulations.
- Potential for increased litigation related to exclusion decisions.
Constitutional Alignment
The bill aligns with the Constitution's general welfare clause, as it aims to prevent fraud and ensure proper use of taxpayer funds in healthcare programs. Congress has the power to legislate in areas related to spending and providing for the general welfare. The Fifth Amendment's due process clause would require fair procedures for excluding individuals or entities, ensuring they have an opportunity to be heard.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).