Page:United States Statutes at Large Volume 110 Part 3.djvu/273

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PUBLIC LAW 104-191—AUG. 21, 1996 110 STAT. 2003 "(c) SPECIAL FRAUD AI^ERTS.— " (1) IN GENERAL.— "(A) REQUEST FOR SPECIAL FRAUD ALERTS. —Any person may present, at any time, a request to the Inspector General for a notice which informs the public of practices which the Inspector General considers to be suspect or of particular concern under the Medicare program under title XVIII or a State health care program, as defined in section 1128(h) (in this subsection referred to as a 'special fraud alert'). "(B) ISSUANCE AND PUBLICATION OF SPECIAL FRAUD ALERTS. —upon receipt of a request described in subparagraph (A), the Inspector General shall investigate the subject matter of the request to determine whether a special fraud alert should be issued. If appropriate, the Inspector General shall issue a special fraud alert in response to the request. All special fraud alerts issued pursuant to this subparagraph shall be published in the Federal Register. "(2) CRITERIA FOR SPECIAL FRAUD ALERTS.—In determining whether to issue a special fraud alert upon a request described in paragraph (1), the Inspector General may consider— "(A) whether and to what extent the practices that would be identified in the special fraud alert may result in any of the consequences described in subsection (a)(2); and "(B) the volume and frequency of the conduct that would be identified in the special fraud alert.". Subtitle B—Revisions to Current Sanctions for Fraud and Abuse SEC. 211. MANDATORY EXCLUSION FROM PARTICIPATION IN MEDI- CARE AND STATE HEALTH CARE PROGRAMS. (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 Port-