Amazingly, the Obama administration has ruled that neither the federal insurance exchange nor the federal subsidies paid to insurance companies on behalf of low-income people are “federal health care programs.”
It appears that subsidized health insurance under the Accountable Care Act is therefore exempt from a law that bans rebates, kickbacks, bribes and certain other financial arrangements in federal health programs, stripping law enforcement of a powerful tool used to fight fraud in other health care programs.
This HHS decision was made despite the fact that the insurance exchanges and subsidy payments appear to fit the definition of federal health care programs in the anti-kickback statute.
No doubt, insurers and providers should be happy about this decision, so they won’t have to worry about pesky things like laws that prohibit kickbacks, fraud, and the like.
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