which entity has jurisdiction over health care coverage providers

We dont do any government work here. 0000006386 00000 n Sign up to get the latest information about your choice of CMS topics. No, as a federal contractor in the State of California you will still need to meet the requirements of Executive Order 11246. The Patient Protection and Affordable Care Act, enacted on March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, enacted on March 30, 2010, (collectively known as the Affordable Care Act)(ACA) reorganized, amended, and added to the provisions of Part A of title XXVII of the PHS Act. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. 0000013829 00000 n Title XXVII of the Public Health Service Act (PHS Act) contemplates that states will exercise primary enforcement authority over health insurance issuers in the group and individual markets to ensure compliance with health insurance market reforms. which entity has jurisdiction over health care coverage providers HHS Argues Covered Entities Cannot Intervene in 340B Drug Pricing Case. Part 60-741.5(a).. Your practice or facility may not be subject to affirmative action laws, so read on to understand whether you should accept this provision in an agreement or not. Under the federal merger control regime, both the FTC and DOJ Antitrust Division have the authority to investigate and challenge mergers. Under Section 503 of the Rehabilitation Act of 1973, as amended (Section 503), a government contractor with 50 or more employees and a Government contract of $50,000 or more must develop a Section 503 AAP. 0000002523 00000 n He can be reached at daniel.anziska@troutman.com. Barbara Sicalides is a Partner in the Business Litigation practice group at Troutman Pepper. Regardless of how small a deal is, the parties need to understand the competitive implications. 18116. Policy form review is one of the compliance tools used to confirm health insurance issuers' compliance with the provisions of the health insurance market reforms of the Affordable Care Act. What is reinsurance example? Please note that a hospital or other health care provider may be a covered contractor because of other contractual arrangements, such as providing health care to active or retired military under a contract with the Department of Veterans Affairs or the Department of Defense. Specifically, the amendments would add a provision virtually identical to Section 2 of the Sherman Act. She advises healthcare clients on the antitrust implications of transactions, defends hospital systems against allegations of antitrust wrongdoing, and prepares pre-merger notification filings for healthcare deals. How the proposed transaction affects competition. lEm 3. Under Section 503, however, all government contracts must meet the dollar threshold amount of $50,000 for coverage. However, in 2015, the FAR implemented an inflationary adjustment for VEVRAA, increasing the threshold amount from $100,000 to $150,000. However, it is reasonable to assume that proof of a dominant position would not require proof of market power because conduct by firms with market power is already addressed by the monopolization section of the amendments. -Doctors' services are covered by Medicare Part B. necessary rule applies to. Whether California (or another state) enacts legislation requiring state approval of transactions. The term "nonpersonal services" includes, but is not limited to, the following services: This definition thus explicitly includes agreements for insurance. 0000002187 00000 n Federal government work is performed in some other division in another state. website belongs to an official government organization in the United States. Is my company covered by the Scheduling Moratorium for Veterans Affairs Health Benefits Program (VAHBP) Providers? lock Yes. Health care system consolidation: Attorney General approval and enforcement, California Senate Bill 977 (2020). If your entity is not subject to affirmative action requirements, make sure you dont inadvertently agree to comply in any contract you may have with a federal contractor. Issuers required to submit form filings to CMS will need to follow instructions posted under Training Resources below. > endobj 65 0 obj << /ProcSet [ /PDF /Text ] /Font << /F1 90 0 R /F2 83 0 R /F3 85 0 R /F4 84 0 R /F5 88 0 R /F6 78 0 R >> /ExtGState << /GS1 102 0 R /GS2 103 0 R >> /ColorSpace << /Cs6 66 0 R /Cs8 67 0 R /Cs9 89 0 R >> >> endobj 66 0 obj [ /ICCBased 107 0 R ] endobj 67 0 obj [ /Separation /PANTONE#205777#20U 66 0 R 104 0 R ] endobj 68 0 obj 2093 endobj 69 0 obj << /Filter /FlateDecode /Length 68 0 R >> stream 0000016173 00000 n The statutory framework for enforcement of non-Federal governmental plans was established in Part A of title XXVII of the PHS Act with the enactment of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). or Which of the following actions is NOT allowed by Health Insurance Counseling and Advocacy Program (HiCAP) counselors? As such, these entities may qualify for these two exceptions to OFCCP coverage for specific types of health care providers. [CDATA[/* >