S. 861: PRIME Act of 2015

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S. 861: PRIME Act of 2015

114th Congress · introduced 2015-03-25 · Health · Latest: Placed on Senate Legislative Calendar under General Orders. Calendar No. 183.

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Official title

PRIME Act of 2015

Plain summary

Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 or the PRIME Act of 2015 (Sec. 2) Amends title XIX (Medicaid) of the Social Security Act (SSAct) to cover the costs of equipment, salaries and benefits, and travel and training in appropriations for the Medicaid Integrity Program. Allows the Department of Health and Human Services (HHS) to increase Centers for Medicare and Medicaid Services staff whose duties consist solely of protecting the integrity of the Medicare program under SSAct title XVIII by a number determined necessary to carry out the Program (currently, by 100). (Sec. 3) Directs HHS to provide incentives for Medicare administrative contractors (MACs) to reduce the improper payment error rates in their jurisdictions. Authorizes among such incentives: a sliding scale of award fee payments and additional incentives to MACs that either reduce the improper payment rates in their jurisdictions to certain HHS-determined thresholds or accomplish tasks that further improve payment accuracy; and substantial reductions in award fee payments under cost-plus-award-fee contracts for MACs that reach an upper end improper payment rate threshold or fail to accomplish tasks that further improve payment accuracy. (Sec. 4) Requires imprisonment for up to 10 years or a fine of up to $500,000 ($1 million in the case of a corporation), or both, for without lawful authority knowingly and willfully purchasing, selling, distributing, or arranging for the purchase, sale, or distribution of a beneficiary identification number or unique health identifier for a health care provider under SSAct titles XVIII, XIX, or XXI (Children's Health Insurance Program) (CHIP). (Sec. 5) Directs HHS to establish a plan to encourage and facilitate the participation of states in the Medicare-Medicaid Data Match Program (Medi-Medi Program). Revises Medi-Medi Data Match Program purposes. Directs HHS to develop and implement a plan that allows state agencies responsible for administering a state Medicaid plan access to relevant data on improper or fraudulent payments made under the Medicare program for health care items or services provided to dual eligible individuals (eligible for both Medicare and Medicaid).

Congressional Research Service summary (Reported to Senate with amendment(s)), quoted unchanged (nonpartisan). Read the source.

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Officials and money

Sponsor: Sen. Carper, Thomas R. [D-DE] · 16 cosponsors

Cost estimate: CBO cost estimate: S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015 (2015-07-15)

Cosponsors on this site

Sheldon Whitehouse (D-RI), Ron Johnson (R-WI), Christopher A. Coons (D-DE), Amy Klobuchar (D-MN), Tom Cotton (R-AR), John Barrasso (R-WY), John Thune (R-SD), Jeanne Shaheen (D-NH), Mark R. Warner (D-VA)

No linked floor roll calls in our collected records yet. This does not mean the bill has never had a vote. Check the official bill history.

Sources

• Congressional Research Service summary (Reported to Senate with amendment(s))
• Congress.gov
• Data: GovInfo BILLSTATUS bulk data (Library of Congress), BILLSTATUS-114s861.xml <https://www.govinfo.gov/bulkdata/BILLSTATUS/114/s>

Record fed-us-cong114-s861 · catalog fed-us-congress-bills-cong114 · updated 2026-11-15 by psicol fed-bills-cong114