Page:United States Statutes at Large Volume 110 Part 3.djvu/262

 110 STAT. 1992 PUBLIC LAW 104-191—AUG. 21, 1996 Subtitle A—Fraud and Abuse Control Program SEC. 201. FRAUD AND ABUSE CONTROL PROGRAM. (a) ESTABLISHMENT OF PROGRAM. —Title XI (42 U.S.C. 1301 et seq.) is amended by inserting after section 1128B the following new section: "FRAUD AND ABUSE CONTROL PROGRAM 42 USC 1320a- "SEC 1128C. (a) ESTABLISHMENT OF PROGRAM. — 7c. "(1) IN GENERAL.— Not later than January 1, 1997, the Secretary, acting through the Office of the Inspector General of the Department of Health and Himian Services, and the Attorney General shall establish a program— "(A) to coordinate Federal, State, and local law enforcement programs to control fraud and abuse with respect to health plans, "(B) to conduct investigations, audits, evaluations, and inspections relating to the delivery of and payment for health care in the United States, "(C) to facilitate the enforcement of the provisions of sections 1128, 1128A, and 1128B and other statutes applicable to health care fraud and abuse, "(D) to provide for the modification and establishment of safe harbors and to issue advisory opinions and special fraud alerts pursuant to section 1128D, and "(E) to provide for the reporting and disclosure of certain final adverse actions against health care providers, suppliers, or practitioners pursuant to the data collection system established under section 1128E. " (2) COORDINATION WITH HEALTH PLANS.— In carrying out the program established under paragraph (1), the Secretary and the Attorney General shall consult with, and arrange for the sharing of data with representatives of health plans. " (3) GUIDELINES.— "(A) IN GENERAL.— The Secretary and the Attorney General shall issue guidelines to carry out the program under paragraph (1). The provisions of sections 553, 556, and 557 of title 5, United States Code, shall not apply in the issuance of such guidelines. "(B) INFORMATION GUIDELINES.— "(i) IN GENERAL.— Such guidelines shall include guidelines relating to the ftmiishing of information by health plans, providers, and others to enable the Secretary and the Attorney General to carry out the program (including coordination with health plans under paragraph (2)). "(ii) CONFIDENTIALITY.—Such guidelines shall include procedures to assure that such information is provided and utilized in a manner that appropriately protects the confidentiality of the information and the privacy of individuals receiving health care services and items. "(iii) QUALIFIED IMMUNITY FOR PROVIDING INFORMATION.— The provisions of section 1157(a) (relat-

�