Page:United States Statutes at Large Volume 91.djvu/1236

 91 STAT. 1202

Application and annual reports, submittal to Secretary.

42 USC 1395b-l.

42 USC 1305. Effective date.

42 USC 1396b note. Regulations.

PUBLIC LAW 95-142—OCT. 25, 1977

and which provide effective coordination of activities between the entity and such office with respect to the detection, investigation, and prosecution of suspected criminal violations relating to the program under this title. "(2) The entity is separate and distinct from the single State • agency that administers or supervises the administration of the State plan under this title. "(3) The entity's function is conducting a statewide program for the investigation and prosecution of violations of all applicable State laws regarding any and all aspects of fraud in connection with any aspect of the provision of medical assistance and the activities of providers of such assistance under the State plan under this title. " (4) The entity has procedures for reviewing complaints of the abuse and neglect of patients of health care facilities which receive payments under the State plan under this title, and, where appropriate, for acting upon such complaints under the criminal laws of the State or for referring them to other State agencies for action. "(5) The entity provides for the collection, or referral for collection to a single State agency, of overpayments that are made under the State plan to health care facilities and that are discovered by the entity in carrying out its activities. " (6) The entity employs such auditors, attorneys, investigators, and other necessary personnel and is organized in such a manner as is necessary to promote the effective and efficient conduct of the entity's activities. "(7) The entity submits to the Secretary an application and annual reports containing such information as the Secretary determines, by regulation, to be necessary to determine whether the entity meets the other requirements of this subsection.". (d) Section 402(a)(1) of the Social Security Amendments of 1967 (Public Law 90-248), as amended by section 222 of the Social Security Amendments of 1972 (Public Law 92-603), is amended— (1) by striking out "and" at the end of subparagraph (H); (2) by striking out the period at the end of subparagraph (I) and inserting in lieu thereof "; and"; and (3) by adding after subparagraph (I) the following new subparagraph: " (J) to develop or demonstrate improved methods for the investigation and prosecution of fraud in the provision of care or services under the health programs established by the Social Security Act.". (e)(1) The amendment made by subsection (a) shall apply with respect to calendar quarters beginning after September 30, 1977. (2) The Secretary of Health, Education, and Welfare shall establish such regulations, not later than ninety days after the date of enactment of this Act, as are necessary to carry out the amendments made by this section. REPORT ON HOME HEALTH AND OTHER I N - H O M E

Report to congressional committees.

42 USC 1395/Z note.

SERVICES

SEC. 18. (a) Not later than one year after the date of enactment of this Act, the Secretary of Health, Education, and Welfare shall submit to the appropriate committees of the Congress a report analyzing,

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