SEC. 211. MANDATORY EXCLUSION FROM PARTICIPATION IN MEDICARE AND STATE HEALTH
CARE PROGRAMS.
Title[ Title II\Subtitle B Contents
Subtitle B--Revisions to Current Sanctions for Fraud and Abuse
(a) Individual Convicted of Felony Relating to Health Care Fraud.--
(1) In general.--Section 1128(a) (42 U.S.C. 1320a-7(a)) is
amended by adding at the end the following new paragraph:
``(3) Felony conviction relating to health care fraud.--Any
individual or entity that has been convicted for an offense
which occurred after the date of the enactment of the Health
Insurance Portability and Accountability Act of 1996, under
Federal or State law, in connection with the delivery of a
health care item or service or with respect to any act or
omission in a health care program (other than those specifically
described in paragraph (1)) operated by or financed in whole or
in part by any Federal, State, or local government agency, of a
criminal offense consisting of a felony relating to fraud,
theft, embezzlement, breach of fiduciary responsibility, or
other financial misconduct.''.
(2) Conforming amendment.--Paragraph (1) of section 1128(b)
(42 U.S.C. 1320a-7(b)) is amended to read as follows:
``(1) Conviction relating to fraud.--Any individual or
entity that has been convicted for an offense which occurred
after the date of the enactment of the Health Insurance
Portability and Accountability Act of 1996, under Federal or
State law--
``(A) of a criminal offense consisting of a
misdemeanor relating to fraud, theft, embezzlement,
breach of fiduciary responsibility, or other financial
misconduct--
``(i) in connection with the delivery of a
health care item or service, or
``(ii) with respect to any act or omission in
a health care program (other than those
specifically described in subsection (a)(1))
operated by or financed in whole or in part by any
Federal, State, or local government agency; or
``(B) of a criminal offense relating to fraud,
theft, embezzlement, breach of fiduciary responsibility,
or other financial misconduct with respect to any act or
omission in a program (other than a health care program)
operated by or financed in whole or in part by any
Federal, State, or local government agency.''.
(b) Individual Convicted of Felony Relating to Controlled
Substance.--
(1) In general.--Section 1128(a) (42 U.S.C. 1320a-7(a)), as
amended by subsection (a), is amended by adding at the end the
following new paragraph:
``(4) Felony conviction relating to controlled substance.--
Any individual or entity that has been convicted for an offense
which occurred after the date of the enactment of the Health
Insurance Portability and Accountability Act of 1996, under
Federal or State law, of a criminal offense consisting of a
felony relating to the unlawful manufacture, distribution,
prescription, or dispensing of a controlled substance.''.
(2) Conforming amendment.--Section 1128(b)(3) (42 U.S.C.
1320a-7(b)(3)) is amended--
(A) in the heading, by striking ``Conviction'' and
inserting ``Misdemeanor conviction''; and
(B) by striking ``criminal offense'' and inserting
``criminal offense consisting of a misdemeanor''.
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