Medicare-Medicaid Anti-Fraud and Abuse Amendments

Medicare-Medicaid Anti-Fraud and Abuse Amendments - Amends provisions of Title XVIII (Medicare) of the Social Security Act which require that Medicare payments be made directly to the physician or other person providing the service involved. Allows payment in accordance with an assignment from the person or institution providing the care or service involved if such assignment is made to a governmental agency or entity or is established by the order of a court of competent jurisdiction or to an agent of such person or institution if the agent does so pursuant to an agency agreement under which the compensation to be paid to the agent for his services or in connection with the billing or collection of payments due such person or institution under the plan is unrelated to the amount of such payments or the billings thereof, and is not dependent upon the actual collection of any such payment.

States that the Secretary of Health, Education, and Welfare shall by regulation (or by contract provision) provide that any entity (other than a public agency) which is a provider or supplier that furnishes, or arranges for the furnishing of, items or services with respect to which payment is claimed under Title XVIII, Title V (Maternal and Child Welfare), or under Title XIX (Medicaid) of the Social Security Act or a party to an agreement with the Secretary under such titles, shall promptly comply with any request, specifically addressed to that entity by the Secretary or the Comptroller General of the United States, for information concerning ownership, control, or costs of such entities.

Increases the penalty for defrauding the Medicare and Medicaid programs from one year imprisonment and a $10,000 fine to five years and a $25,000 fine making such offense a felony (presently a misdemeanor).

Directs that where a Professional Standards Review Organization has been found competent by the Secretary to assume review responsibility with respect to specified types of health services, such reviews shall constitute the conclusive determination on those issues for purposes of payment under the Social Security Act.

Provides that a Professional Standards Review Organization shall provide data and information: (1) to assist Federal and State agencies recognized by the Secretary as having responsibility for identifying and investigating cases or patterns of fraud or abuse; and (2) to assist the Secretary in carrying out appropriate health care planning and related activities.