PUBLIC LAW 95-142—OCT. 25, 1977
91 STAT. 1183
"(d) Whoever knowingly and willfully— Health care "(1) charges, for any service provided to a patient under a facilities, illegal State plan approved under this title, money or other consideration patient admittance and at a rate in excess of the rates established by the State, or retention "(2) charges, solicits, accepts, or receives, in addition to any practices. amount otherwise required to be paid under a State plan approved under this title, any gift, money, donation, or other consideration (other than a charitable, religious, or philanthropic contribution from an organization or from a person unrelated to the patient) — "(A) as a precondition of admitting a patient to a hospital, skilled nursing facility, or intermediate care facility, or "(B) as a requirement for the patient's continued stay in such a facility, when the cost of the services provided therein to the patient is paid for (in whole or in part) under the State plan, shall be guilty of a felony and upon conviction thereof shall be fined not more than $25,000 or imprisoned for not more than five years, or both.". (c) Section 204(a) of Public Law 94-505 (42 U.S.C. 3524) (relating Reports to to annual reports of the Health, Education, and Welfare Inspector Congress, General) is amended by adding at the end thereof the following sen- contents. tences: "Such report also shall include a detailed description of the cases referred by the Department of Health, Education, and Welfare to the Department of Justice during the period covered by the report, an evaluation of the performance of the Department of Justice in the investigation and prosecution of criminal violations relating to fraud in the programs of health insurance and medical assistance provided under titles X VIII and X IX of the Social Security Act, and any 42 USC 1395, recommendations with respect to improving the performance of such 1396. activities by the Department of Justice, Promptly, after the Inspector General submits such a report to Congress, the Attorney General shall report to Congress concerning the details of the disposition of the cases referred to the Department of Justice and described in the Inspector General's report.". (d) The amendments made by subsections (a) and (b) shall apply Effective date. with respect to acts occurring and statements or representations made 42 USC 1395nri note. on or after the date of the enactment of this Act. AMENDMENTS RELATED TO PROFESSIONAL, STANDARDS REVIEW ORGANIZATIONS
SEC. 5. (a) Section 1152(e) of the Social Security Act is amended 42 USC 1320c-l. to read as follows: "(e) Where the Secretary finds a Professional Standards Review Organization (whether designated on a conditional basis or otherwise) to be competent to perform review responsibilities, the review, certification, and similar activities otherwise required pursuant to provisions of this Act (other than this part) shall not be applicable with respect to those providers, suppliers, and practitioners being reviewed by such Professional Standards Review Organization, except to the extent specified by the Secretary. Nothing in the preceding sentence shall be construed as rendering inapplicable any provision of this Act wherein requirements with respect to conditions for eligibility to or payment of benefits (as distinct from reviews and certifications made with respect to determinations of the kind made pursuant to paragraphs (1) and (2) of section 1155(a)) must be satisfied.". 42 USC 1320c-^l..
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