Health Fraud and Abuse Act of 1995

Summary

Health Fraud and Abuse Act of 1995 - Directs the Inspector General (IG) of each of the Departments of Health and Human Services, Defense, Labor, and Veterans Affairs and the Office of Personnel Management to conduct audits, civil and criminal investigations, inspections, and evaluations relating to the prevention, detection, and control of health care fraud and abuse in violation of any Federal law, with exceptions. Sets forth provisions regarding the powers of IGs. Directs the IGs to: (1) jointly establish a program to prevent, detect, and control health care fraud and abuse which considers the activities of Federal, State, and local law enforcement agencies (LEAs), Federal and State agencies responsible for the licensing and certification of health care providers, and State agencies designated under this Act; (2) develop an annual investigative plan; and (3) regularly consult with each other, such LEAs, Federal and State agencies responsible for the licensing and certification of health care providers, and Health Care Fraud and Abuse Control Units. Requires the Governor of each State to designate State agencies which conduct, supervise, and coordinate audits, civil and criminal investigations, inspections, and evaluations relating to such prevention, detection, and control. Authorizes each Governor to establish and maintain a State agency to act as a Health Care Fraud and Abuse Control Unit. Requires that each Unit be a single identifiable entity of State government which is separate and distinct from any State agency with principal responsibility for the administration of health care programs and which meets specified requirements, such as being a unit of the State Attorney General or other State department that possesses statewide authority to prosecute individuals for criminal violations. Authorizes each Unit to submit each year to the IG a plan for preventing, detecting, and controlling health care fraud and abuse. Sets forth provisions regarding: (1) IG approval of annual plans; (2) reporting requirements; (3) payments to States; and (4) data sharing. Establishes: (1) the Health Care Fraud and Abuse Control Account in the Treasury; and (2) the Account Payments Advisory Board which shall make recommendations to the IGs regarding the equitable allocation of payments from the Account.

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3 official files

• Introduced in House (text)

  Introduced in House · EN · 14 June 1995

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• Introduced in House (PDF)

  Introduced in House · EN · 14 June 1995

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• Introduced in House

  summary · EN · 14 June 1995

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