PRINTER'S NO. 781
No. 700 Session of 1989
INTRODUCED BY KUKOVICH, JAROLIN, PRESSMANN, RITTER, ITKIN,
RICHARDSON, CAWLEY, HASAY, JACKSON, TIGUE, HAYDEN, MAIALE,
BLAUM, FEE, BELARDI, GIGLIOTTI, DeLUCA, KOSINSKI, COWELL,
VEON, CAPPABIANCA, FREEMAN, VAN HORNE, MICHLOVIC, LASHINGER,
TANGRETTI, JOSEPHS, KASUNIC, TRELLO, ROBINSON, YANDRISEVITS,
LAUGHLIN, MURPHY, HUGHES, PRESTON, DALEY, ACOSTA, PIEVSKY,
OLIVER, ROEBUCK, PERZEL, STISH, J. TAYLOR, RYBAK, CARN,
HARPER, WESTON, LEVDANSKY, MELIO, COLAIZZO, R. C. WRIGHT,
COHEN, RIEGER, HOWLETT, WILLIAMS, WAMBACH, BISHOP, LINTON,
JAMES, DONATUCCI, THOMAS, CALTAGIRONE, DOMBROWSKI, MRKONIC,
PISTELLA, D. W. SNYDER, RUDY, McHALE, EVANS, KAISER, SALOOM,
PETRARCA, BURD, MAINE, LUCYK, CORNELL, SCRIMENTI AND
DIETTERICK, MARCH 13, 1989
REFERRED TO COMMITTEE ON HEALTH AND WELFARE, MARCH 13, 1989
AN ACT
1 Prohibiting overcharges by health care practitioners for
2 services to certain patients.
3 The General Assembly of the Commonwealth of Pennsylvania
4 hereby enacts as follows:
5 Section 1. Short title.
6 This act shall be known and may be cited as the Medicare
7 Overcharge Act.
8 Section 2. Purposes.
9 (a) Legislative finding.--The General Assembly finds that
10 there exists in this Commonwealth a major crisis because of the
11 continuing escalation of costs for health care services. Because
12 of the continuing escalation of costs, an increasingly large
1 number of Pennsylvania citizens have severely limited access to
2 appropriate and timely health care. Senior citizens and the
3 disabled are disadvantaged by the continuing escalation of costs
4 for health care services. Increasing costs are also undermining
5 the quality of health care services currently being provided.
6 Further, the continuing escalation is negatively affecting the
7 economy of this Commonwealth and is restricting new economic
8 growth and impeding the creation of new job opportunities in
9 this Commonwealth.
10 (b) Declaration of policy.--The General Assembly declares
11 its policy to be that every person in this Commonwealth should
12 receive timely and appropriate health care services from any
13 provider operating in this Commonwealth; and that each provider
14 should offer and provide medically necessary health care
15 services to every person in this Commonwealth and should not
16 charge or collect from a beneficiary of health insurance under
17 Title XVIII of the Social Security Act (Public Law 74-271, 42
18 U.S.C. § 301 et seq.), known as the Medicare Program, an amount
19 in excess of the reasonable charge for the service provided, as
20 determined by the United States Secretary of Health and Human
21 Services.
22 Section 3. Definitions.
23 The following words and phrases when used in this act shall
24 have the meanings given to them in this section unless the
25 context clearly indicates otherwise:
26 "Healing arts." The science and skill of diagnosis,
27 prevention or treatment, in any manner whatsoever, of disease or
28 any ailment of the human body.
29 "Health care practitioner." An individual who is authorized
30 to practice some component of the healing arts by a license,
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1 permit, certificate or registration issued by a Commonwealth
2 licensing agency or board. The term includes, but is not limited
3 to, a medical doctor, an osteopathic physician, a chiropractor,
4 a dentist, an optometrist, a pharmacist, a physical therapist, a
5 podiatrist, a professional nurse and a psychologist.
6 Section 4. Overcharges by health care practitioners prohibited.
7 It shall be unlawful for any health care practitioner, or any
8 primary health center, corporation, facility, institution or
9 other entity that employs a health care practitioner, to charge
10 or collect from a beneficiary of health insurance under Title
11 XVIII of the Social Security Act (Public Law 74-271, 42 U.S.C. §
12 301 et seq.), known as the Medicare Program, an amount in excess
13 of the reasonable charge for the service provided, as determined
14 by the United States Secretary of Health and Human Services.
15 Section 5. Penalties.
16 (a) Public reprimand.--A violation of section 4 of this act
17 shall subject the violating health care practitioner to a public
18 reprimand by the agency or board under which the practitioner is
19 licensed.
20 (b) Restitution.--In addition to the penalty imposed under
21 subsection (a), a health care practitioner that violates section
22 4 shall be ordered, by the agency or board which licensed it, to
23 repay to the victim the amount of the excess payments received,
24 plus interest on that amount at the maximum legal rate from the
25 date payment was made until the date repayment is made.
26 (c) Fine.--The board or agency under which a health care
27 practitioner is licensed shall impose the following fines:
28 (1) On a health care practitioner that is found to have
29 violated section 4 for a second time, $2,000.
30 (2) On a health care practitioner that is found to have
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1 violated section 4 for a third or subsequent time, $5,000.
2 (d) Other disciplinary action.--A third or subsequent
3 violation of section 4 shall be grounds for the refusal,
4 revocation or suspension of a license, permit, certificate or
5 registration to practice any of the healing arts, and for the
6 imposition of other disciplinary action against a health care
7 practitioner that is found to have violated section 4.
8 Section 6. Effective date.
9 This act shall take effect in 60 days.
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