Ted Kaufman - United States Senator for Delaware

Kaufman Applauds Historic Signing of Health Care Reform Bill into Law

Final bill includes Kaufman provisions to strengthen tools to investigate, prosecute and punish health care criminals

March 23, 2010

WASHINGTON, D.C. – Senator Ted Kaufman (D-DE) on Tuesday stood by his Congressional colleagues in the East Room of the White House as President Barack Obama signed the historic health care reform bill into law.

“This is truly an historic day,” Kaufman said. “After decades of efforts and a year of extensive debate, Americans – in Delaware and across the country – will finally have a health care system that controls costs, reduces the deficit, improves access, adds more protections for seniors and curbs insurance company abuses. The President has signed meaningful health care reform into law that will extend immediate benefits to millions of American families and small businesses.” 

Kaufman, the primary sponsor of the Health Care Fraud Enforcement Act, also highlighted the inclusion of provisions from this bill, which was introduced last October. These provisions strengthen the government’s capacity to investigate and prosecute waste, fraud and abuse in both government and private health insurance that is estimated to cost as much as $220 billion annually.  

Co-sponsors of the Health Care Fraud Enforcement Act include Senators Patrick Leahy (D-VT), Arlen Specter (D-PA), Herb Kohl (D-WI), Chuck Schumer (D-NY), Amy Klobuchar (D-MN) and Tom Harkin (D-IA).

“We worked hard to develop these provisions with the Administration and to ensure they remained in the final bill,” Kaufman continued. “These are low-cost, high reward solutions that go a long way toward bending the cost curve down, and ultimately reducing the deficit. They also include a series of critical changes to the law to ensure health care criminals are punished not only commensurate with the costs they impose on the system, but also at a level that will offer real deterrence.”
More specifically, the fraud enforcement provisions make straightforward but critical improvements to the federal sentencing guidelines, to health care fraud statutes, and to forfeiture, money laundering, and obstruction statutes, all of which will strengthen prosecutors’ ability to combat this particularly destructive form of fraud. These improvements include:

o Sentencing increases:  The bill directs the Sentencing Commission to increase the guidelines for health care fraud offenses, by 20-50% for crimes that involve more than $1,000,000 in losses.

o Redefining “health care fraud offense”:  The bill includes all health care crimes within the definition of “health care fraud offense,” regardless of where they are codified.  (ERISA, drug marketing, and kickback crimes are currently not included)  This change will make available to law enforcement the full range of antifraud tools, including criminal forfeiture and obstruction penalties, to combat these offenses.

o Improving whistleblower claims: Kickbacks lead to unnecessary and risky medical care and pervert the doctor-patient relationship.  This bill clarifies that all payments made pursuant to illegal kickbacks are false for purposes of the False Claims Act.

o Creating a common-sense mental state requirement for health care fraud offenses: Some courts have held that defendants must be aware that their conduct violates a specific provision of criminal law in order to be held accountable. This bill restores the original intent of Congress that a person is guilty of a health care offense if he knowingly does what the law forbids.



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