What is required after a life agent sells an insurance policy to an applicant without being appointed by the insurer? Under this collaborative approach, if the state finds a potential violation and is unable to obtain voluntary compliance from an issuer, it will refer the matter to CMS for possible enforcement action. Share sensitive information only on official, secure websites. Barbara Sicalides is a Partner in the Business Litigation practice group at Troutman Pepper. Further, except for universities and medical facilities, a state or local government agency, instrumentality, or subdivision that has a government contract is exempt from the requirement to develop and maintain a written affirmative action program. It would make it unlawful under state law: for any person or persons to monopolize, or attempt to monopolize, or combine or conspire with any other person or persons to monopolize any business, trade or commerce or the furnishing of any service in this state.33. lock RCW 19.390.080. For providers serving rural areas, the attorney general would have the authority to waive these standards.22 .dol-alert-status-error .alert-status-container {display:inline;font-size:1.4em;color:#e31c3d;} 2. 0000006386 00000 n In addition to the premerger notification provision, SB 977 also targeted conduct by healthcare systems. HlW$5|y~8N3|-oOU93-.?G9b?w]vg,TTTu_>z#:HOTH%SO>cavF^OvK>R$l]aSbgu?sVdYpv|C}`,Z#MH#}-^U"} $sF'tq7i!G?>:835^27LX SB 977 required the California attorney general to reject a transaction if the parties failed to show that it will result in a substantial likelihood of clinical integration, a substantial likelihood of increasing or maintaining the availability and access of services to an underserved population, or both.21 Even if the parties demonstrated clinical integration and increased access, the legislation gave the attorney general the discretion to reject a transaction if there was a substantial likelihood that the transaction would lead to anticompetitive effects, such as increased prices, diminished quality or access, and reduced choice, that outweigh any benefits of a substantial likelihood of clinical integration or an increase or maintenance of services to an underserved population. What is Medi? States and CMS have worked closely to ensure compliance with the health insurance accountability and consumer protections in federal law. 0000009634 00000 n OFCCPs policy is that the receipt of reimbursements from a health insurance carrier that provides a health benefits plan under the FEHB Program, for the medical services provided to federal employees or their dependents, will not provide a basis for coverage of the hospital or other health care provider under the laws enforced by OFCCP. The ARB determined that the reimbursement agreement did not provide a basis for coverage of the hospital under the laws enforced by OFCCP. 0000015627 00000 n Likewise, a teaching hospital doing research for a university that has a contract with the federal government may be a covered federal contractor. Pursuant to this authority, CMS may investigate and implement corrective action or impose civil monetary penalties for any non-Federal governmental plan that fails to comply with applicable PHS Act requirements. . Federal Reserve Bank of Boston v. Commissioner of Corporations and Taxation of the Commonwealth of Massachusetts, 499 F.2d 60 (1st Cir. What is reinsurance example? 18116. Before sharing sensitive information, make sure youre on a federal government site. This document is intended only to provide clarity to the public regarding existing requirements under the law or agency policies. .table thead th {background-color:#f1f1f1;color:#222;} 0000018799 00000 n Regardless of how small a deal is, the parties need to understand the competitive implications. This deal analysis should include talking to business personnel, reviewing relevant documents, and potentially, analyzing patient draw data. An official website of the United States government For questions and concerns regarding non-Federal governmental plans, please e-mail NonFed@cms.hhs.gov. 4212 (VEVRAA) as under Section 503 for any government contractor with 50 or more employees and a contract of $50,000 or more to serve as a depository of federal funds or as an issuing and paying agent for savings bonds and notes, if the Government contract was entered into before December 1, 2003. As such, these entities may qualify for these two exceptions to OFCCP coverage for specific types of health care providers. The implementing regulations for Executive Order 11246 at 41 CFR 60-1.3, for VEVRAA at 41 CFR 60-300.2 and for Section 503 at 41 CFR 60-741.2, consistently define a government contract as any agreement or modification thereof between any contracting agency and any person for the purchase, sale or use of personal property or nonpersonal services. Is my company covered by the Scheduling Moratorium for Veterans Affairs Health Benefits Program (VAHBP) Providers? Missouri Generally speaking, once it has been determined that a business or organization is subject to the equal employment opportunity requirements enforced by OFCCP, all of the businesss or organizations establishments or facilities will be subject to the same regulatory requirements, regardless of where the federal contract is to be performed. She can be reached at barbara.sicalides@troutman.com. Health Care Clearinghousesentities that process nonstandard health information they receive from another entity into a standard (i.e., standard electronic format or data content), or vice versa. In Colorado, legislators recently expanded the states ability to challenge all mergers, not only healthcare transactions, by repealing a statutory provision that curbed its enforcement power.3 Although Colorado did not create a system for premerger notification, it did give the Colorado attorney general the ability to challenge transactions regardless of whether the federal antitrust authorities object to those deals. Watch out for this language! 0000004716 00000 n The term "health care providers," as used in the TRICARE Exemption and VAHBP Moratorium, is easily interpreted to include providers like blood banks, diagnostic labs, or ambulance services.
