101 STAT. 680
PUBLIC LAW 100-93—AUG. 18, 1987
Public Law 100-93 100th Congress
•V3'
An Act Aug. 18, 1987 [H.R. 1444]
Medicare and Medicaid Patient and Program Protection Act of 1987. 42 USC 1305 note.
To amend titles XI, XVIII, and XIX of the Social Security Act to protect beneficiaries under the health care programs of that Act from unfit health care practitioners, and otherwise to improve the antifraud provisions relating to those programs.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE; REFERENCES IN ACT; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the "Medicare and
Medicaid Patient and Program Protection Act of 1987". (b) AMENDMENTS TO THE SOCIAL SECURITY ACT.—Except as otherwise specifically provided, whenever in this Act an amendment is expressed in terms of an amendment to or repeal of, a section or other provision, the reference shall be considered to be made to that section or other provision of the Social Security Act. (c) TABLE OF CONTENTS.—The table of contents of this Act is as follows: Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec.
1. 2. 3. 4.
Short title; references in Act; table of contents. Exclusion from medicare and State health care programs. Civil monetary penalties. Criminal penalties for acts involving medicare and State health care programs. 5. Information concerning sanctions taken by State licensing authorities against health care practitioners and providers. 6. Obligation of health care practitioners and providers. 7. Exclusion under the medicaid program. 8. Miscellaneous and conforming amendments. 9. Clarification of medicaid moratorium provisions of Deficit Reduction Act of 1984. 10. Limitation of liability of medicare beneficiaries with respect to services furnished by excluded individuals and entities. 11. Definition of person with ownership or control interest. 12. Conditional approval of renal dialysis facilities. 13. Amendment relating to fraud involving medicare supplemental insurance. 14. Standards for anti-kickback provisions. 15. Effective dates.
SEC. 2. EXCLUSION FROM PROGRAMS.
MEDICARE
AND
STATE
HEALTH
CARE
Section 1128 (42 U.S.C. 1320a-7) is amended to read as follows: E X C L U S I O N O F CERTAIN INDIVIDUALS AND ENTITIES FROM PARTICIPATION IN MEDICARE AND STATE HEALTH CARE PROGRAMS "SEC. 1128. (a) MANDATORY EXCLUSION.—The Secretary shall ex-
42 USC 1395.
clude the following individuals and entities from participation in any program under title XVIII and shall direct that the following individuals and entities be excluded from participation in any State health care program (as defined in subsection (h)): "(1) CONVICTION OF PROGRAM-RELATED CRIMES.—Any individ-
ual or entity that has been convicted of a criminal offense
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