December 18, 2014
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December 15, 2014
The Impact of the 2010 Health Reform Law on Hospitals
The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act (collectively the “Health Reform Law”) contain major changes that impact hospitals, including:
- Payment and delivery of care reform;
- New IRS requirements for tax-exempt hospitals; and
- Enhanced fraud & abuse enforcement, through:
- Expansion of the RAC program;
- Changes to the Stark & Anti-Kickback laws and False Claims Act; and
- New program integrity measures.
- RAC Expansion. The Health Reform Law expands the Recovery Audit Contractor (RAC) program by requiring all state Medicaid programs to contract with one or more RACs by December 2010, and also by expanding the RAC program to Medicare Part C (Medicare’s HMO program) and Part D (Medicare’s prescription drug benefit program).
- Changes to the Anti-Kickback & Stark Laws and FCA, along with New Program Integrity Measures. The Health Reform Law also contains several provisions aimed at decreasing fraud and abuse by increasing transparency, funding, and enforcement. The foregoing is accomplished through changes to the Stark and Anti-Kickback laws, amendments to the False Claims Act, and many new program integrity measures.
This communication provides general information and is not intended to provide legal advice. Should you require legal advice, you should seek the assistance of counsel.