Laws: Cases and Codes : U.S. Code : Title 42 : Section 1320a-7b
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U.S. Code as of:
01/19/04
Section 1320a-7b - Notes
SOURCE
(Aug. 14, 1935, ch. 531, title XI, Sec. 1128B, formerly title
XVIII, Sec. 1877(d), and title XIX, Sec. 1909, as added and amended
Pub. L. 92-603, title II, Secs. 242(c), 278(b)(9), Oct. 30, 1972,
86 Stat. 1419, 1454; Pub. L. 95-142, Sec. 4(a), (b), Oct. 25, 1977,
91 Stat. 1179, 1181; Pub. L. 96-499, title IX, Sec. 917, Dec. 5,
1980, 94 Stat. 2625; Pub. L. 98-369, div. B, title III, Sec.
2306(f)(2), July 18, 1984, 98 Stat. 1073; renumbered title XI, Sec.
1128B, and amended Pub. L. 100-93, Secs. 4(a)-(d), 14(b), Aug. 18,
1987, 101 Stat. 688, 689, 697; Pub. L. 100-203, title IV, Secs.
4039(a), 4211(h)(7), Dec. 22, 1987, 101 Stat. 1330-81, 1330-206;
Pub. L. 100-360, title IV, Sec. 411(a)(3)(A), (B)(i), July 1, 1988,
102 Stat. 768; Pub. L. 101-239, title VI, Sec. 6003(g)(3)(D)(ii),
Dec. 19, 1989, 103 Stat. 2153; Pub. L. 101-508, title IV, Secs.
4161(a)(4), 4164(b)(2), Nov. 5, 1990, 104 Stat. 1388-94, 1388-102;
Pub. L. 103-432, title I, Sec. 133(a)(2), Oct. 31, 1994, 108 Stat.
4421; Pub. L. 104-191, title II, Secs. 204(a), 216(a), 217, Aug.
21, 1996, 110 Stat. 1999, 2007, 2008; Pub. L. 105-33, title IV,
Secs. 4201(c)(1), 4704(b), 4734, Aug. 5, 1997, 111 Stat. 373, 498,
522; Pub. L. 108-173, title I, Sec. 101(e)(2), (8)(A), title II,
Sec. 237(d), title IV, Sec. 431(a), Dec. 8, 2003, 117 Stat. 2150,
2152, 2213, 2287.)
AMENDMENT OF SUBSECTION (B)(3)
Pub. L. 108-173, title II, Sec. 237(d), (e), Dec. 8, 2003, 117
Stat. 2213, provided that, applicable to services provided on or
after Jan. 1, 2006, and contract years beginning on or after such
date, subsection (b)(3) of this section is amended as follows:
(1) in subparagraph (F), by striking "and" after the semicolon at
the end;
(2) in subparagraph (G), by striking the period at the end and
inserting "; and"; and
(3) by adding at the end the following new subparagraph:
REFERENCES IN TEXT
Part B of subchapter XVIII of this chapter, referred to in
subsec. (b)(3)(D), is classified to section 1395j et seq. of this
title.
The Public Health Service Act, referred to in subsec. (b)(3)(D),
is act July 1, 1944, ch. 373, 58 Stat. 682, as amended, which is
classified generally to chapter 6A (Sec. 201 et seq.) of this
title. For complete classification of this Act to the Code, see
Short Title note set out under section 201 of this title and
Tables.
Section 14(a) of the Medicare and Medicaid Patient and Program
Protection Act of 1987, referred to in subsec. (b)(3)(E), is
section 14(a) of Pub. L. 100-93, which is set out below.
Section 1395w-104(e)(6) of this title, referred to in subsec.
(b)(3)(E), was in the original "section 1860D-3(e)(6)", and was
translated as reading "section 1860D-4(e)(6)" to reflect the
probable intent of Congress, because section 1860D-3, which is
classified to section 1395w-103 of this title, does not contain a
subsec. (e), and section 1395w-104(e)(6) relates to regulations.
Part D of subchapter XVIII of this chapter, referred to in
subsec. (b)(3)(G), is classified to section 1395w-101 et seq. of
this title.
CODIFICATION
Prior to redesignation by Pub. L. 100-93, subsecs. (a) to (d) of
this section were subsecs. (a) to (d) of section 1909 of act Aug.
14, 1935, which was classified to section 1396h of this title, and
subsec. (e) of this section was subsec. (d) of section 1877 of act
Aug. 14, 1935, which was classified to section 1395nn of this
title.
AMENDMENTS
2003 - Subsec. (b)(3)(E). Pub. L. 108-173, Sec. 101(e)(8)(A),
which directed the amendment of subpar. (C) by inserting "or in
regulations under section 1395w-104(e)(6) of this title" after
"1987", was executed by making the insertion in subpar. (E) to
reflect the probable intent of Congress because "1987" does not
appear in subpar. (C).
Subsec. (b)(3)(G). Pub. L. 108-173, Sec. 101(e)(2), added subpar.
(G).
Subsec. (b)(3)(H). Pub. L. 108-173, Sec. 431(a), added subpar.
(H).
1997 - Subsec. (a). Pub. L. 105-33, Sec. 4734(2), in cl. (ii) of
concluding provisions, substituted "failure, conversion, or
provision of counsel or assistance by any other person" for
"failure, or conversion by any other person".
Subsec. (a)(6). Pub. L. 105-33, Sec. 4734(1), added par. (6) and
struck out former par. (6) which read as follows: "knowingly and
willfully disposes of assets (including by any transfer in trust)
in order for an individual to become eligible for medical
assistance under a State plan under subchapter XIX of this chapter,
if disposing of the assets results in the imposition of a period of
ineligibility for such assistance under section 1396p(c) of this
title,".
Subsec. (c). Pub. L. 105-33, Sec. 4201(c)(1), substituted
"critical access" for "rural primary care".
Subsec. (d)(1). Pub. L. 105-33, Sec. 4704(b), inserted "(or, in
the case of services provided to an individual enrolled with a
medicaid managed care organization under subchapter XIX of this
chapter under a contract under section 1396b(m) of this title or
under a contractual, referral, or other arrangement under such
contract, at a rate in excess of the rate permitted under such
contract)" after "by the State".
1996 - Pub. L. 104-191, Sec. 204(a)(1), substituted "Federal" for
"Medicare or State" in section catchline.
Subsec. (a). Pub. L. 104-191, Sec. 204(a)(4), in concluding
provisions, substituted "a Federal health care program" for "a
State plan approved under subchapter XIX of this chapter" and "the
administrator of such program may at its option (notwithstanding
any other provision of such program)" for "the State may at its
option (notwithstanding any other provision of that subchapter or
of such plan)".
Subsec. (a)(1). Pub. L. 104-191, Sec. 204(a)(2), substituted "a
Federal health care program (as defined in subsection (f) of this
section)" for "a program under subchapter XVIII of this chapter or
a State health care program (as defined in section 1320a-7(h) of
this title)".
Subsec. (a)(5). Pub. L. 104-191, Sec. 204(a)(3), substituted "a
Federal" for "a program under subchapter XVIII of this chapter or a
State".
Subsec. (a)(6). Pub. L. 104-191, Sec. 217, added par. (6).
Subsec. (b). Pub. L. 104-191, Sec. 204(a)(5), substituted "a
Federal health care program" for "subchapter XVIII of this chapter
or a State health care program" wherever appearing.
Subsec. (b)(3)(F). Pub. L. 104-191, Sec. 216(a), added subpar.
(F).
Subsec. (c). Pub. L. 104-191, Sec. 204(a)(6), inserted "(as
defined in section 1320a-7(h) of this title)" after "a State health
care program".
Subsec. (f). Pub. L. 104-191, Sec. 204(a)(7), added subsec. (f).
1994 - Subsec. (b)(3)(B). Pub. L. 103-432, which directed
substitution of "1395m(j)(5)" for "1395m(j)(4)" in subpar. (B) as
amended by section 134(a) of Pub. L. 103-432, could not be executed
because "1395m(j)(4)" does not appear in subpar. (B) and section
134(a) of Pub. L. 103-432 did not amend this section.
1990 - Subsec. (b)(3)(D), (E). Pub. L. 101-508, Sec. 4161(a)(4),
added subpar. (D) and redesignated former subpar. (D) as (E).
Subsec. (c). Pub. L. 101-508, Sec. 4164(b)(2), substituted
"health care program, or with respect to information required to be
provided under section 1320a-3a of this title," for "health care
program".
1989 - Subsec. (c). Pub. L. 101-239 inserted "rural primary care
hospital," after "hospital,".
1988 - Subsec. (c). Pub. L. 100-360 made technical correction to
directory language of Pub. L. 100-203, Sec. 4039(a), see 1987
Amendment note below.
Pub. L. 100-203, Sec. 4211(h)(7)(A), substituted "nursing
facility, intermediate care facility for the mentally retarded" for
"intermediate care facility".
Subsec. (d)(2)(A). Pub. L. 100-203, Sec. 4211(h)(7)(B),
substituted "nursing facility, or intermediate care facility for
the mentally retarded" for "skilled nursing facility, or
intermediate care facility".
1987 - Pub. L. 100-93, Sec. 4(a)(1), substituted "Criminal
penalties for acts involving Medicare or State health care
programs" for "Offenses and penalties" in section catchline.
Subsec. (a). Pub. L. 100-93, Sec. 4(a)(3), (4), in concluding
provisions, substituted "made under the program" for "made under
this subchapter", "approved under subchapter XIX of this chapter"
for "approved under this subchapter", and "provision of that
subchapter" for "provision of this subchapter".
Subsec. (a)(1). Pub. L. 100-93, Sec. 4(a)(2), substituted "a
program under subchapter XVIII of this chapter or a State health
care program (as defined in section 1320a-7(h) of this title)" for
"a State plan approved under this subchapter".
Subsec. (a)(5). Pub. L. 100-93, Sec. 4(b), added par. (5).
Subsec. (b)(1)(A), (B), (2)(A), (B). Pub. L. 100-93, Sec.
4(a)(5), substituted "subchapter XVIII of this chapter or a State
health care program" for "this subchapter".
Subsec. (b)(3). Pub. L. 100-93, Secs. 4(a)(5), (6), 14(b),
substituted "subchapter XVIII of this chapter or a State health
care program" for "this subchapter" in two places in subpar. (A)
and added subpars. (C) and (D).
Subsec. (c). Pub. L. 100-203, Sec. 4039(a), as amended by Pub. L.
100-360, substituted "institution, facility, or entity" for
"institution or facility" wherever appearing and inserted
"(including an eligible organization under section 1395mm(b) of
this title)" after "other entity".
Pub. L. 100-93, Sec. 4(a)(7), substituted "home health agency, or
other entity for which certification is required under subchapter
XVIII of this chapter or a State health care program" for "or home
health agency (as those terms are employed in this subchapter)".
Subsec. (d)(1), (2). Pub. L. 100-93, Sec. 4(a)(8), substituted
"subchapter XIX of this chapter" for "this subchapter".
Subsec. (e). Pub. L. 100-93, Sec. 4(c), redesignated subsec. (d)
of section 1395nn of this title as subsec. (e) of this section.
1984 - Subsec. (e). Pub. L. 98-369 inserted "or agrees to be a
participating physician or supplier under section 1395u(h)(1) of
this title" after "section 1395u(b)(3)(B)(ii) of this title", and
substituted "or agreement" for "specified in subclause (I) of such
section".
1980 - Subsec. (b)(1), (2). Pub. L. 96-499 inserted "knowingly
and willfully" after "Whoever".
1977 - Subsec. (a). Pub. L. 95-142, Sec. 4(b), designated
existing provisions following par. (4) as cl. (ii) and, as so
designated, inserted provisions relating to activities of other
persons, and inserted provisions authorizing the State to limit,
restrict, or suspend, the eligibility of any convicted persons for
benefits, and added cl. (i). See Codification note above.
Subsec. (b). Pub. L. 95-142, Sec. 4(b), redesignated existing
provisions as par. (1), substituted provisions relating to
solicitation or receiving of any remuneration in return for
referring an individual to a person for the furnishing or arranging
the furnishing of any item or service, or in return for purchasing,
leasing, ordering, or arranging for or recommending purchasing,
etc., as constituting a felony punishable by a fine of not more
than $25,000 and/or imprisonment for not more than five years, for
provisions relating to furnishing items or services and soliciting,
offering or receiving any kickback, bribe, or rebate in connection
with furnishing, etc. items or services as constituting a
misdemeanor punishable by a fine of not more than $10,000 and/or
imprisonment for not more than one year, and added pars. (2) and
(3). See Codification note above.
Subsec. (c). Pub. L. 95-142, Sec. 4(b), substituted provisions
setting forth felony nature of criminal activities with a fine of
not more than $25,000, or imprisonment for not more than five
years, or both, for provisions setting forth misdemeanor nature of
criminal activities with a fine of not more than $2,000, or
imprisonment for not more than six months, or both. See
Codification note above.
Subsec. (d). Pub. L. 95-142, Sec. 4(b), added subsec. (d). See
Codification note above.
Subsec. (e). Pub. L. 95-142, Sec. 4(a), added subsec. (e). See
Codification note above.
1972 - Subsec. (c). Pub. L. 92-603, Sec. 278(b)(9), substituted
"skilled nursing facility" for "skilled nursing home".
SECTION REFERRED TO IN OTHER SECTIONS
This section is referred to in sections 1320a-3a, 1320a-7,
1320a-7a, 1320a-7c, 1320a-7d, 1320a-7e, 1395b-5, 1395w-104,
1395w-141, 1396b, 1396r-6, 1397gg of this title.
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