Pennsylvania House Bill HB1355

Pennsylvania 2023-2024 Regular Session

• Introduced: 6/9/23
• Refer: 6/9/23

Caption

In fraud and abuse control, further providing for definitions and for provider prohibited acts, criminal penalties and civil remedies.

Impact

If enacted, HB 1355 will significantly impact state laws by providing clearer definitions and a more extensive list of actions deemed illegal, thus strengthening the state’s ability to combat fraud within the medical assistance program. The amendment will allow the state to impose felony charges for severe violations, such as knowingly submitting false claims that lead to substantial financial gains. This will effectively restructure the legal framework governing how healthcare providers operate within the state, emphasizing compliance and integrity in their dealings.

Summary

House Bill 1355 is a legislative proposal aimed at amending the existing laws regarding fraud and abuse control under the Human Services Code in Pennsylvania. The bill seeks to enhance definitions related to provider conduct and expand the list of prohibited acts associated with the medical assistance program. Notably, it introduces stricter criminal penalties and civil remedies for individuals who engage in fraudulent activities in relation to claims submitted for medical services. This legislative action is part of a broader initiative to ensure accountability and integrity within the medical assistance system.

Sentiment

The sentiment surrounding HB 1355 appears to be generally supportive among lawmakers who prioritize the reduction of fraud within the medical assistance program. Proponents argue that these reforms will help safeguard taxpayer dollars and improve the overall efficacy of healthcare services. However, there may be concerns raised from healthcare providers regarding the potential for increased scrutiny and the implications of stricter penalties, which could create apprehension over compliance costs and operational challenges.

Contention

Notable points of contention might arise around the broad definitions and scope of what constitutes fraudulent activity, as critics may argue that the language employed in HB 1355 could lead to overreach in enforcement. There is also a potential debate over how these amended regulations may affect the willingness of providers to serve patients under the medical assistance program, which could, in turn, impact access to care for vulnerable populations. Legislative discussions may focus on finding a balance between necessary oversight and the operational realities faced by healthcare providers.