Page:United States Statutes at Large Volume 124.djvu/781

 124 STAT. 755 PUBLIC LAW 111–148—MAR. 23, 2010 including a prescribing physician’s medical records for an indi- vidual who is prescribed an item or service which is covered under part B of title XVIII, a covered part D drug (as defined in section 1860D–2(e)) for which payment is made under an MA–PD plan under part C of such title, or a prescription drug plan under part D of such title, and any records necessary for evaluation of the economy, efficiency, and effectiveness of the programs under titles XVIII and XIX. ‘‘(c) ADMINISTRATIVE REMEDY FOR KNOWING PARTICIPATION BY BENEFICIARY IN HEALTH CARE FRAUD SCHEME.— ‘‘(1) IN GENERAL.—In addition to any other applicable rem- edies, if an applicable individual has knowingly participated in a Federal health care fraud offense or a conspiracy to commit a Federal health care fraud offense, the Secretary shall impose an appropriate administrative penalty commensurate with the offense or conspiracy. ‘‘(2) APPLICABLE INDIVIDUAL.—For purposes of paragraph (1), the term ‘applicable individual’ means an individual— ‘‘(A) entitled to, or enrolled for, benefits under part A of title XVIII or enrolled under part B of such title; ‘‘(B) eligible for medical assistance under a State plan under title XIX or under a waiver of such plan; or ‘‘(C) eligible for child health assistance under a child health plan under title XXI. ‘‘(d) REPORTING AND RETURNING OF OVERPAYMENTS.— ‘‘(1) IN GENERAL.—If a person has received an overpayment, the person shall— ‘‘(A) report and return the overpayment to the Sec- retary, the State, an intermediary, a carrier, or a con- tractor, as appropriate, at the correct address; and ‘‘(B) notify the Secretary, State, intermediary, carrier, or contractor to whom the overpayment was returned in writing of the reason for the overpayment. ‘‘(2) DEADLINE FOR REPORTING AND RETURNING OVERPAY- MENTS.—An overpayment must be reported and returned under paragraph (1) by the later of— ‘‘(A) the date which is 60 days after the date on which the overpayment was identified; or ‘‘(B) the date any corresponding cost report is due, if applicable. ‘‘(3) ENFORCEMENT.—Any overpayment retained by a per- son after the deadline for reporting and returning the overpay- ment under paragraph (2) is an obligation (as defined in section 3729(b)(3) of title 31, United States Code) for purposes of section 3729 of such title. ‘‘(4) DEFINITIONS.—In this subsection: ‘‘(A) KNOWING AND KNOWINGLY.—The terms ‘knowing’ and ‘knowingly’ have the meaning given those terms in section 3729(b) of title 31, United States Code. ‘‘(B) OVERPAYMENT.—The term ‘‘overpayment’’ means any funds that a person receives or retains under title XVIII or XIX to which the person, after applicable reconcili- ation, is not entitled under such title. ‘‘(C) PERSON.— ‘‘(i) IN GENERAL.—The term ‘person’ means a pro- vider of services, supplier, medicaid managed care organization (as defined in section 1903(m)(1)(A)), Notification. Definition. Penalty.