Section 1909 of the Social Security Act provides a financial incentive for states to enact their own false claims acts.
On September 12, 2011, the United States Department of Health & Human Services (HHS) announced proposed rules that will enable direct access to laboratory test results by patients.
On September 12, 2011, HHS Secretary Kathleen Sebelius announced a proposed rule entitled, CLIA Program and HIPAA Privacy Rule; Patients’ Access to Test Reports.
Final rules published September 16, 2011 to implement section 6411: Expansion of the Recovery Audit Contractor Program.
On May 23, 2011, the Center for Consumer Information & Insurance Oversight (CCIIO), in the Centers for Medicare & Medicaid Services (CMS) of the United States Department of Health and Human Services (HHS) published its Final Rule implementing Section 2794 of the Public Health Service Act (PHSA).
The Treasury, DOL, and the Department of Health and Human Services jointly issued amendments to the interim final rules governing the internal claims and appeals and the external review processes required under the Patient Protection and Affordable Care Act (PPACA)
As summarized in a previous FR Alert, non-grandfathered group health plans are subject to new claims and appeals requirements under the Patient Protection and Affordable Care Act, as modified by the Health Care and Education Reconciliation Act of 2010.
New regulations provide some relief and clarification for plan administrators processing group health plan claims.
Health care reform requires non-grandfathered group health plans, both insured and self-insured, to change their internal claims procedures and external review procedures.
The Departments of Labor, Treasury and Health and Human Services have amended the interim final rule issued in July 2010 regarding internal claims and appeals and external review requirements under the Patient Protection and Affordable Care Act ("PPACA").