text: SECTION 1. SHORT TITLE; REFERENCES IN ACT.
  
      (a) Short Title.--This Act may be cited as the ``Health Care Fraud 
  and Abuse Advisory Opinion Act of 1994''.
      (b) References in Act.--Except as otherwise specifically provided, 
  whenever an amendment herein is expressed in terms of an amendment to, 
  or repeal of a section or other provision, the reference shall be 
  considered to be made to that section or other provision of the Social 
  Security Act.
  
  SEC. 2. AUTHORIZING THE SECRETARY OF HEALTH AND HUMAN SERVICES TO ISSUE 
                ADVISORY OPINIONS UNDER TITLE XI.
  
      (a) Authorization.--Title XI, section 1128 (42 U.S.C. 1320a-7) is 
  amended by the addition of the following new paragraph:
      ``(j) The Secretary shall issue advisory opinions as provided in 
  this section.
              ``(1) Matters subject to advisory opinions.--The Secretary 
          shall issue advisory opinions as to the following matters:
                      ``(i) What constitutes prohibited remuneration 
                  within the meaning of section 1320a-7b(b) of title 42, 
                  United States Code.
                      ``(ii) Whether an arrangement or proposed 
                  arrangement satisfies the criteria set forth in section 
                  1320a-7b(b)(3) of title 42, United States Code as 
                  amended for activities which do not result in 
                  prohibited remuneration.
                      ``(iii) Whether an arrangement or proposed 
                  arrangement satisfies the criteria which the Secretary 
                  has established, or shall establish by regulation for 
                  activities which do not result in prohibited 
                  remuneration.
                      ``(iv) What constitutes an inducement to reduce or 
                  limit services to individuals entitled to benefits 
                  under part A or part B of title XVIII or title XIX 
                  within the meaning of section 1320a-7a(b) of title 42, 
                  United States Code.
                      ``(v) Whether an arrangement, activity or proposed 
                  arrangement or proposed activity violates any other 
                  provision of the Act.
              ``(2) Matters not subject to advisory opinions.--Such 
          advisory opinions shall not address the following matters:
                      ``(i) Whether the fair market value shall be, or 
                  was paid or received for any goods, services or 
                  property.
                      ``(ii) Whether an individual is a bona fide 
                  employee within the requirements of section 3121(d)(2) 
                  of title 26, United States Code.
              ``(3) Effect of advisory opinions.--
                      ``(i) Each advisory opinion issued by the Secretary 
                  shall be binding as to the Secretary and the party or 
                  parties requesting the opinion.
                      ``(ii) The failure of a party to seek an advisory 
                  opinion may not be introduced into evidence to prove 
                  that the party intended to violate the provisions of 
                  sections 1320a-7, 1320a-7(a), or 1320a-7(b) of title 
                  42, United States Code.
              ``(4) Regulations.--The Secretary within one hundred and 
          eighty days of the date of enactment, shall issue regulations 
          establishing a system for the issuance of advisory opinions. 
          Such regulations shall provide for--
                      ``(i) the procedure to be followed by a party 
                  applying for an advisory opinion;
                      ``(ii) the procedure to be followed by the 
                  Secretary in responding to a request for an advisory 
                  opinion;
                      ``(iii) the interval in which the Secretary shall 
                  respond;
                      ``(iv) the reasonable fee to be charged to the 
                  party requesting an advisory opinion; and
                      ``(v) the manner in which advisory opinions will be 
                  made available to the public.
              ``(5) Interval for issuance of advisory opinions.--Under no 
          circumstances shall the interval in which the Secretary shall 
          respond to a party requesting an advisory opinion exceed 30 
          days.''.
  
  SEC. 3. AUTHORIZING THE SECRETARY OF HEALTH AND HUMAN SERVICES TO ISSUE 
                ADVISORY OPINIONS UNDER TITLE XVIII.
  
      (a) Authorization.--Title XVIII, section 1877 (42 U.S.C. 1395nn) is 
  amended by the addition of the following new paragraph:
      ``(i)(1) Advisory Opinions.--The Secretary shall issue advisory 
  opinions on whether an arrangement or proposed arrangement will result 
  in a prohibited referral within the meaning of section 1395nn of title 
  42, United States Code, as amended.
      ``(2) Effect of Advisory Opinions.--
              ``(i) Each advisory opinion issued by the Secretary shall 
          be binding as to the Secretary and the party or parties 
          requesting the opinion.
              ``(ii) The failure of a party to seek an advisory opinion 
          may not be introduced into evidence to prove that the party 
          intended to violate the provisions of section 1395nn of title 
          42, United States Code.
      ``(3) Regulations.--The Secretary within one hundred and eighty 
  days of the date of enactment, shall issue regulations establishing a 
  system for the issuance of advisory opinions. Such regulations shall 
  provide for--
              ``(i) the procedure to be followed by a party applying for 
          an advisory opinion;
              ``(ii) the procedure to be followed by the Secretary in 
          responding to a request for an advisory opinion;
              ``(iii) the interval in which the Secretary shall respond;
              ``(iv) the reasonable fee to be charged to the party 
          requesting an advisory opinion; and
              ``(v) the manner in which advisory opinions will be made 
          available to the public.
      ``(4) Interval for Issuance of Advisory Opinions.--Under no 
  circumstances shall the interval in which the Secretary shall respond 
  to a party requesting an advisory opinion exceed thirty days.''.
  
  SEC. 4. EFFECTIVE DATE.
  
      Unless otherwise specified herein, the Health Care Fraud and Abuse 
  Advisory Opinion Act of 1994 shall be effective upon enactment.
target: Health Care Fraud and Abuse Advisory Opinion Act of 1994 - Amends title XI of the Social Security Act (SSA) to give the Secretary of Health and Human Services the authority to issue binding advisory opinions addressing certain matters, such as what constitutes prohibited remuneration or an inducement to reduce or limit Medicare or Medicaid services, and whether an arrangement or activity, actual or proposed, violates any other SSA provisions. 
  Amends SSA title XVIII (Medicare) to give the Secretary the authority to issue binding advisory opinions on whether an arrangement or proposed arrangement will result in a prohibited physician referral. 
  Requires the Secretary to issue regulations establishing systems for the issuance of the advisory opinions above.
feat_title: Health Care Fraud and Abuse Advisory Opinion Act of 1994