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H.R. 1083

BillFederalHouseIn Committee
Medicaid Physician Self-Referral Act of 2015
About This Bill
Committee
Latest Action · March 27, 2015
Referred to the Subcommittee on Health.
Congress
114th (2015–2017)
Introduced
February 25, 2015
Cosponsors (0)
None
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Summary

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Medicaid Physician Self-Referral Act of 2015 Amends title XIX (Medicaid) of the Social Security Act (SSAct) with respect to physician self-referral limitations to repeal the prohibition against payment of federal funds to a state for medical assistance expenditures for a designated health service furnished to an individual on the basis of a referral (self-referral) that would result in denial of payment under SSAct title XVIII (Medicare). Requires a state plan for medical assistance to prohibit payment for a Medicaid designated health service furnished to an individual on the basis of a physician's referral if the physician (or an immediate family member) has an ownership or investment interest or a compensation arrangement with the entity furnishing the service that would not comply with Medicare requirements. Requires application of certain reporting requirements and sanctions to a provider of a Medicaid designated health service the same way they apply under Medicare. Amends SSAct title XVIII to: (1) apply the False Claims Act to violations of the self-referral prohibition, and (2) declare the authority of the Secretary of Health and Human Services to issue regulations under Medicaid limited to the application of self-referral limitations to state plan requirements. Directs the Secretary to establish a protocol consistent with the Medicare self-referral disclosure protocol required under the Patient Protection and Affordable Care Act that enables health care providers to disclose an actual or potential violation of Medicare self-referral limitations as applied to Medicaid.

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