Marketplace Plans Not Subject to Anti-Kickback Statute

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On October 30, 2013, the Secretary of the Department of Health and Human Services (“DHHS”), Kathleen Sebelius (“Secretary”), released a letter to Congressman Jim McDermott (D-WA) answering the question of whether qualified health plans (“QHPs”) purchased through the Affordable Care Act’s (“ACA”) marketplaces are subject to the Anti-Kickback Statute.

For the Anti-Kickback Statute to apply, the QHPs must be considered a “federal health care program” as defined by the Anti-Kickback Statute. “Federal health care program” is defined as “any plan or program that provides health benefits, whether directly, through insurance, or otherwise, which is funded directly, in whole or in part, by the United States Government…or any State health care program….”

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Topics:  Affordable Care Act, Anti-Kickback Statute, Health Insurance Exchanges, HHS, Qualified Health Plans

Published In: Health Updates, Insurance Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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