News & Analysis as of

Anti-Kickback Statute Patient Protection and Affordable Care Act (PPACA) Health Insurance Exchanges

The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The... more +
The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The statute aims to prevent situations where government officials channel federal healthcare dollars towards particular providers, who have offered or given the official a personal benefit. Penalties for violation of the Anti-Kickback statute apply to both sides of a prohibited transaction and can include jail time and steep monetary fines. less -
Dickinson Wright

Do Subsidized Health Care Plans Purchased Under the Affordable Care Act Trigger the Anti-Kickback Statute?

Dickinson Wright on

The advent of federally subsidized private pay health insurance under the Affordable Care Act has the potential to expand the application of the federal anti-kickback statute beyond just Medicare, Medicaid, and Tricare. The...more

BakerHostetler

HHS's Mixed Messages: Identifying a Federal Healthcare Program When You See It

BakerHostetler on

Recent seemingly contrary determinations by the U.S. Department of Health and Human Services (HHS) have fueled industry speculation regarding whether qualified health plans (QHPs) available on the health insurance exchanges...more

Mintz - Health Care Viewpoints

Are Exchange Health Plans Federal Health Care Programs, and Therefore Subject to Anti-Kickback Statutes?

Background - As we reported earlier this week, Rep. Jim McDermott, the ranking Democrat on the Ways and Means Health Subcommittee in the House of Representatives, received a response to his August 6 letter to Secretary...more

Baker Donelson

Dodging the AKS: Marketplace Plans Are Not "Federal Health Care Programs"

Baker Donelson on

In an October 30th letter addressed to Congressman Jim McDermott, the Department of Health and Human Services (HHS) Secretary, Kathleen Sebelius, left little to interpretation: Qualified health plans (QHPs) purchased through...more

Davis Wright Tremaine LLP

Sebelius: "Qualified Health Plans Are Not Federal Health Care Programs"

In a letter to Rep. Jim McDermott dated Oct. 30, 2013, Department of Health and Human Services Secretary Kathleen Sebelius clarified that qualified health plans (“QHPs”) available on the health insurance exchanges under the...more

McDermott Will & Emery

HHS Clarifies that ACA Qualified Health Plans are Not Subject to Federal Anti-Kickback Statute; Expresses Concern about Providers...

McDermott Will & Emery on

The U.S. Department of Health and Human Services recently announced that Qualified Health Plans (sold on and off the Exchanges) are not “Federal health care programs” for purposes of the federal anti-kickback statute. The...more

Mintz - Health Care Viewpoints

HHS Announces That ACA Exchange Plans Are Not “Federal Health Care Programs”

In a surprising move late last week, HHS Secretary Kathleen Sebelius announced that qualified health plans (QHPs) purchased through the Affordable Care Act’s (ACA) insurance exchanges are not “federal health care programs”...more

Baker Donelson

HHS: Providers May Be Able to Subsidize Premiums For Uninsured in Marketplace Plans

Baker Donelson on

An announcement October 30 from Health and Human Services Secretary Kathleen Sebelius could remove the first hurdle for providers wishing to offer premium support for individuals eligible for health insurance on the Health...more

Polsinelli

Health Reform + Related Health Policy News - June 2013

Polsinelli on

In This Issue: - Top News ..CMS Finalizes MLR Rule for Plans, Maintaining Application to Part D Sponsors ..Early State Filings Show Premium Reductions under ACA ..HHS Received More Than 830 Letters of...more

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