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医疗保健项目:欺诈与滥用;1996年《健康保险流通与责任法案》导致的监察长办公室(OIG)民事罚款修订——卫生与公众服务部监察长办公室(OIG)。拟议规则制定通知。

Health care programs: fraud and abuse; revised OIG civil money penalties resulting from the Health Insurance Portability and Accountability Act of 1996--Office of Inspector General (OIG), HHS. Notice of proposed rulemaking.

出版信息

Fed Regist. 1998 Mar 25;63(57):14393-402.

PMID:10177752
Abstract

This proposed rule would revise the OIG's civil money penalty (CMP) authorities, in conjunction with new and revised provisions set forth in the Health Insurance Portability and Accountability Act of 1996. Among other provisions, this proposed rulemaking would codify new CMPs for: Excluded individuals retaining ownership or control interest in an entity; upcoding and claims for medically unnecessary services; offering inducements to beneficiaries; and false certification of eligibility for home health services. This rule would also codify a number of technical and conforming changes consistent with the OIG's existing sanction authorities.

摘要

本拟议规则将修订监察长办公室的民事罚款(CMP)权力,同时结合1996年《健康保险流通与责任法案》中规定的新条款和修订条款。除其他条款外,本次拟议规则制定将编纂针对以下行为的新民事罚款:被排除人员在实体中保留所有权或控制权权益;对医疗不必要服务进行高码计费和索赔;向受益人提供诱因;以及对家庭健康服务资格进行虚假认证。本规则还将编纂一些与监察长办公室现有制裁权力一致的技术和一致性变更。

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