H.R. 3200/Division B/Title VI/Subtitle D

==SUBTITLE D — ACCESS TO INFORMATION NEEDED TO PREVENT FRAUD, WASTE, AND ABUSE==

Sec. 1651. Access to Information Necessary to Identify Fraud, Waste, and Abuse. edit

Section 1128G of the Social Security Act, as added by section 1631 and amended by sections 1632 and 1641, is further amended by adding at the end the following new subsection;


``(d) Access to Information Necessary To Identify Fraud, Waste, and Abuse.—For purposes of law enforcement activity, and to the extent consistent with applicable disclosure, privacy, and security laws, including the Health Insurance Portability and Accountability Act of 1996 and the Privacy Act of 1974, and subject to any information systems security requirements enacted by law or otherwise required by the Secretary, the Attorney General shall have access, facilitation by the Inspector General of the Department of Health and Human Services, to claims and payment data relating to titles XVIII and XIX, in consultation with the Centers for Medicare & Medicaid Services or the owner of such data.´´.


Sec. 1652. Elimination of Duplication Between the Healthcare Integrity and Protection Data Bank and the National Practitioner Data Bank. edit

(a) In General.—
To eliminate duplication between the Healthcare Integrity and Protection Data Bank (HIPDB) established under section 1128E of the Social Security Act and the National Practitioner Data Bank (NPBD) established under the Health Care Quality Improvement Act of 1986, section 1128E of the Social Security Act (42 U.S.C. 1320a–7e) is amended—
(1) in subsection (a), by striking ``Not later than´´ and inserting ``Subject to subsection (h), not later than´´;
(2) in the first sentence of subsection (d)(2), by striking ``(other than with respect to requests by Federal agencies)´´; and
(3) by adding at the end the following new subsection:


``(h) Sunset of the healthcare integrity and protection data bank; transition process.—Effective upon the enactment of this subsection, the Secretary shall implement a process to eliminate duplication between the Healthcare Integrity and Protection Data Bank (in this subsection referred to as the ‘HIPDB’ established pursuant to subsection (a) and the National Practitioner Data Bank (in this subsection referred to as the ‘NPDB’) as implemented under the Health Care Quality Improvement Act of 1986 and section 1921 of this Act, including systems testing necessary to ensure that information formerly collected in the HIPDB will be accessible through the NPDB, and other activities necessary to eliminate duplication between the two data banks. Upon the completion of such process, notwithstanding any other provision of law, the Secretary shall cease the operation of the HIPDB and shall collect information required to be reported under the preceding provisions of this section in the NPDB. Except as otherwise provided in this subsection, the provisions of subsections (a) through (g) shall continue to apply with respect to the reporting of (or failure to report), access to, and other treatment of the information specified in this section.´´.


(b) Elimination of the Responsibility of the HHS Office of the Inspector General.—
Section 1128C(a)(1) of the Social Security Act (42 U.S.C. 1320a–7c(a)(1)) is amended—
(1) in subparagraph (C), by adding at the end ``and´´;
(2) in subparagraph (D), by striking at the end ``, and´´ and inserting a period; and
(3) by striking subparagraph (E).
(c) Special Provision for Access to the National Practitioner Data Bank by the Department of Veterans Affairs.—
(1) In General.—
Notwithstanding any other provision of law, during the one year period that begins on the effective date specified in subsection (e)(1), the information described in paragraph (2) shall be available from the National Practitioner Data Bank (described in section 1921 of the Social Security Act) to the Secretary of Veterans Affairs without charge.
(2) Information Described.—
For purposes of paragraph (1), the information described in this paragraph is the information that would, but for the amendments made by this section, have been available to the Secretary of Veterans Affairs from the Healthcare Integrity and Protection Data Bank.
(d) Funding.—
Notwithstanding any provisions of this Act, sections 1128E(d)(2) and 1817(k)(3) of the Social Security Act, or any other provision of law, there shall be available for carrying out the transition process under section 1128E(h) of the Social Security Act over the period required to complete such process, and for operation of the National Practitioner Data Bank until such process is completed, without fiscal year limitation—
(1) any fees collected pursuant to section 1128E(d)(2) of such Act; and
(2) such additional amounts as necessary, from appropriations available to the Secretary and to the Office of the Inspector General of the Department of Health and Human Services under clauses (i) and (ii), respectively, of section 1817(k)(3)(A) of such Act, for costs of such activities during the first 12 months following the date of the enactment of this Act.
(e) Effective Date.—
The amendments made—
(1) by subsection (a)(2) shall take effect on the first day after the Secretary of Health and Human Services certifies that the process implemented pursuant to section 1128E(h) of the Social Security Act (as added by subsection (a)(3)) is complete; and
(2) by subsection (b) shall take effect on the earlier of the date specified in paragraph (1) or the first day of the second succeeding fiscal year after the fiscal year during which this Act is enacted.


Sec. 1653. Compliance with HIPAA Privacy and Security Standards. edit

The provisions of sections 262(a) and 264 of the Health Insurance Portability and Accountability Act of 1996 (and standards promulgated pursuant to such sections) and the Privacy Act of 1974 shall apply with respect to the provisions of this subtitle and amendments made by this subtitle.