Punishing Health Care Fraudsters Act

Summary

Increases criminal penalties for health-care fraud and related kickback offenses by raising maximum prison terms and some monetary thresholds, and directs the U.S. Sentencing Commission to review and, if appropriate, strengthen federal sentencing guidelines for those crimes. The tougher penalties apply to offenses and acts that occur on or after the law’s enactment. The bill raises the statutory maximums for health-care fraud convictions (including an enhanced maximum), updates several criminal penalties and dollar thresholds under the Social Security Act related to kickbacks, and requires the Sentencing Commission to consider specific aggravating and mitigating factors and to align guidelines with the seriousness and growing incidence of these offenses.

• Increases the general maximum prison term for health-care fraud from 10 years to 25 years.
• Raises an enhanced maximum prison term for certain health-care fraud offenses to 30 years.
• Increases multiple criminal penalties and dollar thresholds in Social Security Act anti-kickback provisions, and lengthens a six-month term to one year.
• All penalty increases apply to offenses and acts committed on or after the date of enactment.
• Directs the U.S. Sentencing Commission to review and, if appropriate, amend sentencing guidelines for health-care fraud and kickback offenses.
• Requires the Sentencing Commission to consider loss, sophistication, intent to harm, privacy violations, threats to public health, role/duration, and other factors when revising guidelines.
• Does not provide new appropriations; it changes statutory penalties and requires regulatory/guideline updates.
• Could increase deterrence and punishments but may also raise caseloads for prosecutors, defenders, and courts and affect federal prison populations.