HHS to McDermott: Qualified Health Plans Are Not Federal Health Care Programs
WASHINGTON, DC – Representative Jim McDermott (D-WA) received a letter yesterday from Secretary of Health and Human Services Kathleen Sebelius indicating that qualified health plans ("QHPs") are not considered federal health care programs.
The letter came in response to an August 6 inquiry from Congressman McDermott asking for clarification on whether the agency considers QHPs sold on the exchange to be federal health care programs for purposes of the fraud and abuse laws, including the federal Anti-Kickback Statute. The response also indicates that HHS has certain protections in place to ensure conduct is appropriate in the health insurance marketplaces.
McDermott sent the letter after recognizing that the federal Anti-Kickback Statute could apply to potentially prohibit certain conduct by such plans, including offering assistance with premiums to persons who are unable to afford their premiums on the exchanges, if such plans were deemed federal health care programs.