News & Analysis as of

Exclusions Patient Protection and Affordable Care Act (PPACA)

Quarles & Brady LLP

Is Your Employee or Contractor Excluded?

Quarles & Brady LLP on

Employers must check its employees, contractors and vendors to see if an individual or organization is excluded from participating in federal and/or state programs. While there are a variety of exclusion programs at the...more

Tucker Arensberg, P.C.

HHS Issues Rules Expanding OIG’s Exclusion Authorities

Tucker Arensberg, P.C. on

On January 12, 2017, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) issued final rules implementing permissive exclusion authorities authorized by the Affordable Care Act expanding...more

Cooley LLP

Blog: OIG Issues Final Rule Re: Exclusion Authority

Cooley LLP on

The Final Rule related to the Health and Human Services Office of Inspector General’s (OIG) exclusion authority pursuant to the Social Security Act (the Act), as amended by the Affordable Care Act (ACA) and the Medicare...more

Hogan Lovells

HHS OIG Finalizes New Exclusion Rules as Administration Exits

Hogan Lovells on

With just a week left before a new administration takes office, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) finalized changes to the regulations authorizing OIG to exclude...more

Seyfarth Shaw LLP

Court Smacks Down Plaintiff’s “[But Mom…] Everyone Else Is Doing It” Public Policy Argument To Void Illegal Exclusions Provisions

Seyfarth Shaw LLP on

Seyfarth Synopsis: A Court ruled that under the Affordable Care Act, an ERISA governed plan exclusion cannot unequivocally bar emergency medical care related to injuries sustained in a fireworks explosion. Recently, a...more

Seyfarth Shaw LLP

Suing Not Too Wisely

Seyfarth Shaw LLP on

Seyfarth Synopsis: A district court in Minnesota recently found an employee could not challenge a plan’s blanket transgender exclusion under Title VII, when the employee was not transgender but her son was. The Court went on...more

Cozen O'Connor

Proposed Expansion of OIG’s Exclusion Authority

Cozen O'Connor on

In May, the Office of Inspector General of the Department of Health and Human Services (OIG) proposed a new rule (Rule) that would implement changes included in the ACA. The Rule would expand OIG’s authority to exclude...more

Baker Donelson

OIG Proposes Updates to Exclusion and CMP Authority

Baker Donelson on

The Department of Health and Human Services, Office of Inspector General (OIG) recently issued a pair of proposed regulations to update its exclusion and civil monetary penalty (CMP) authority. The proposed regulations...more

BakerHostetler

OIG Revamps Regulations Concerning CMPs and Exclusion

BakerHostetler on

In a pair of proposed rules published in May, the HHS OIG unveiled changes to the regulations concerning OIG’s authority to impose civil monetary penalties (CMPs) and exclude individuals and entities from participation in...more

Epstein Becker & Green

New Proposed Rules Significantly Expand OIG's Exclusion Power

Epstein Becker & Green on

On May 9, 2014, the Office of Inspector General ("OIG") of the Department of Health and Human Services published in the Federal Register a proposed rule amending the regulations relating to OIG's exclusion authority...more

King & Spalding

OIG Issues Proposed Rules on Its Exclusion and CMP Authorities

King & Spalding on

OIG has issued two proposed rules that would expand the agency’s ability to impose certain sanctions on entities and individuals involved with Federal health care programs. OIG’s first proposed rule—published in the Federal...more

Proskauer - Employee Benefits & Executive...

Coverage of Dependents: Final “Pay-or-Play” Regulations Exclude Stepchildren and Others; Extend Prior Transitional Relief

As previously reported, the IRS recently released final regulations on the Affordable Care Act’s (ACA) employer “shared responsibility” provisions, also known as the “pay-or-play” mandate. Under the mandate, in order to avoid...more

King & Spalding

HRSA Issues Final 340B Orphan Drug Exclusion Rule: Agency’s Narrow Interpretation of Statutory Prohibition Puts Compliance...

King & Spalding on

On July 23, 2013, the Health Resources and Services Administration (HRSA) issued a final rule clarifying the orphan drug exclusion for certain covered entities created by the Affordable Care Act (ACA) (“Final Rule”). The...more

Morgan Lewis

OIG Revises Special Advisory Bulletin on Exclusions

Morgan Lewis on

OIG continues its aggressive interpretation of scope and effect of exclusion from participation in Federal health care programs and clarifies several open questions....more

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