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医疗保险和州医疗保健计划:欺诈与滥用;《反回扣法》安全港条款及关于受益人诱导的民事罚款规则的修订。最终规则。

Medicare and State Health Care Programs: Fraud and Abuse; Revisions to the Safe Harbors Under the Anti-Kickback Statute and Civil Monetary Penalty Rules Regarding Beneficiary Inducements. Final rule.

出版信息

Fed Regist. 2016 Dec 7;81(235):88368-409.

Abstract

In this final rule, OIG amends the safe harbors to the anti-kickback statute by adding new safe harbors that protect certain payment practices and business arrangements from sanctions under the anti-kickback statute. The OIG also amends the civil monetary penalty (CMP) rules by codifying revisions to the definition of "remuneration," added by the Balanced Budget Act (BBA) of 1997 and the Patient Protection and Affordable Care Act, Public Law 111-148, 124 Stat. 119 (2010), as amended by the Health Care and Education Reconciliation Act of 2010 (ACA). This rule updates the existing safe harbor regulations and enhances flexibility for providers and others to engage in health care business arrangements to improve efficiency and access to quality care while protecting programs and patients from fraud and abuse.

摘要

在本最终规则中,监察长办公室(OIG)对反回扣法规的安全港条款进行修订,新增了一些安全港条款,以保护某些支付行为和商业安排免受反回扣法规的制裁。OIG还通过编纂对“报酬”定义的修订内容来修正民事货币处罚(CMP)规则,该定义修订由1997年《平衡预算法案》(BBA)以及《患者保护与平价医疗法案》(公法111 - 148,第124号法令,第119条,2010年)作出,并经2010年《医疗保健与教育协调法案》(ACA)修订。本规则更新了现有的安全港法规,增强了提供者及其他各方参与医疗保健商业安排的灵活性,以提高效率并促进获得优质护理,同时保护相关项目和患者免受欺诈与滥用行为的侵害。

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