,,ii #aac? ,,congress #a/ ,session ,s4 #agbc ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,novemb] #ai1 #bjac,mr4 ,vitt] introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ,a ,,bill ,to cl>ify t ! anti-kickback laws apply to qualifi$ heal? plans1 ! f$]ally-facilitat$ m>ketplaces1 & o!r plans & programs "u title ,i ( ! ,pati5t ,protection & ,af=dable ,c>e ,act1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,no ,obamac>e ,kickbacks ,act ( #bjac4 #b4 ,f9d+s ,! ,congress f9ds ! foll[+3 7#a7 ,section #fdjb7;f7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7,public ,law #aaa-adh7 applies ! civil p5alties & damages = violations ( ! ,false ,claims ,act to kickbacks & o!r acts involv+ ,f$]al heal? c>e programs t are subject to crim9al p5alties "u section #aabh;,b ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;b74 7#b7 ,9 guidance issu$ on ,novemb] #d1 #bjac1 by ! ,c5t] = ,consum] ,in=mation ,insurance ,ov]sight 7,,cciio7 ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 ! ,,cciio /at$ t ! ,dep>tm5t ( ,heal? & ,human ,s]vices 7,,hhs7 has broad au?ority to regulate ! ,f$]al & ,/ate ,m>ketplaces 7e4g4 section #acba7;a7 ( ! ,af=dable ,c>e ,act74 ,! ,novemb] #d? /atem5t f ! ,,cciio sugge/s t qualifi$ heal? plans & o!r heal? c>e plans & programs e/abli%$ "u title ,i ( ! ,pati5t ,protection & ,af=dable ,c>e ,act are simil> to o!r ,f$]al heal? c>e programs1 su* z ! ,m$ic>e ,advantage program1 ov] :i* ! ,secret>y ( ,heal? & ,human ,s]vices also has broad regulatory au?ority4 7#c7 ,! private heal? insurance issu]s :o (f] qualifi$ heal? plans ?r\gh m>ketplaces e/abli%$ "u ! ,pati5t ,protection & ,af=dable ,c>e ,act & ! private heal? insurance issu]s t (f] ,m$ic>e ,advantage plans "u ! ,m$ic>e program bo? receive ,f$]al doll>s directly f ! ,f$]al ,gov]nm5t1 ) ! issu]s ( qualifi$ heal? plans receiv+ ,f$]al doll>s ?r\gh tax cr$it subsidies & ! issu]s ( ,m$ic>e ,advantage plans receiv+ paym5ts f ! ,m$ic>e ,tru/ ,funds4 7#d7 ,! ,f$]al ,gov]nm5t facilitates applications = & enrollm5t 9 qualifi$ heal? plans ?r\gh ! f$]ally-facilitat$ m>ketplaces & ,/ate ex*anges 9 a simil> mann] to ! way ! ,f$]al ,gov]nm5t facilitates applications = & enrollm5t 9 plans "u ! ,m$ic>e ,advantage program & ! ,volunt>y ,prescription ,drug ,b5efit ,program ?r\gh f$]ally fund$ call c5t]s1 web portals1 & consum] assi/ance p]sonnel4 7#e7 ,! ,m$ic>e ,advantage program is a ,f$]al heal? c>e program to :i* ! anti-kickback provisions ( section #aabh;,b7b7 ( ! ,social ,security ,act & o!r prohibit$ acts involv+ ,f$]al heal? c>e programs are subject to civil & crim9al p5alties "u ! ,social ,security ,act z well z civil p5alties "u ! ,false ,claims ,act4 #c4 ,cl>ification ( application ( anti-kickback laws to qualifi$ heal? plans1 m>ketplaces1 & o!r plans & programs "u ,,ppaca 7a7 ,9 g5]al ,section #aabh;,b7f77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;b7f77#a77 is am5d$ by ins]t+ be=e ! semicolon ! foll[+3 1 includ+ any plan or program e/abli%$ or fund$ "u subtitle ,d or ,e 7or ! am5dm5ts made by su* subtitles7 ( title ,i ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7includ+ ! f$]ally-facilitat$ m>ketplaces & ,/ate ,ex*anges1 pati5t navigators1 & relat$ programs e/abli%$ by su* ,act1 z well z any contract ) an individual or entity hir$ by ! ,f$]al ,gov]nm5t to facilitate enrollm5t 9 ! f$]ally-facilitat$ m>ketplaces74 7b7 ,effective date ,! am5dm5t made by subsection 7a7 %all take effect z if includ$ 9 ! enactm5t ( ! ,pati5t ,protection & ,af=dable ,c>e ,act4 #d4 ,,hhs ,,oig & ,,gao jo9t /udy & report 7a7 ,/udy ,! ,inspector ,g5]al ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices & ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all jo9tly conduct a /udy reg>d+ ! effect ( apply+ ! anti-kickback laws & o!r prohibit$ acts involv+ ,f$]al heal? c>e programs to qualifi$ heal? plans1 f$]ally-facilitat$ m>ketplaces & ,/ate ,ex*anges1 & any o!r plan or program e/abli%$ or fund$ "u subtitle ,d or ,e 7or ! am5dm5ts made by su* subtitles7 ( title ,i ( ! ,pati5t ,protection & ,af=dable ,c>e ,act4 ,9 conduct+ ! /udy1 ! ,inspector ,g5]al & ,comptroll] ,g5]al %all-- 7#a7 id5tify all plans & programs t satisfy ! def9ition ( ,f$]al heal? c>e program "u section #aabh;,b7f7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;b7f77 7z am5d$ by section #c7;a772 7#b7 id5tify any entity or individual t w\ld b5efit f hav+ qualifi$ heal? plans1 f$]ally-facilitat$ m>ketplaces1 & any o!r plan or program e/abli%$ or fund$ "u subtitle ,d or ,e 7or ! am5dm5ts made by su* subtitles7 ( title ,i ( ! ,pati5t ,protection & ,af=dable ,c>e ,act exclud$ f ! def9ition ( ,f$]al heal? c>e program "u section #aabh;,b7f7 ( ! ,social ,security ,act 7z s am5d$72 & 7#c7 sep>ately e/imate ) respect to ea* ( ! foll[+1 ! impact ( exclud+ qualifi$ heal? plans1 f$]ally-facilitat$ m>ketplaces & ,/ate ,ex*anges1 & any o!r plan or program e/abli%$ or fund$ "u subtitle ,d or ,e 7or ! am5dm5ts made by su* subtitles7 ( title ,i ( ! ,pati5t ,protection & ,af=dable ,c>e ,act f ! def9ition ( ,f$]al heal? c>e program "u section #aabh;,b7f7 ( ! ,social ,security ,act 7z s am5d$73 7,a7 ,heal? c>e premiums 7) & )\t non-f$]ally fund$ subsidies74 7,b7 ,consum] *oice 9 heal? insurance cov]age4 7,c7 ,! use ( br& "n v]sus g5]ic drugs4 7,d7 ,! net co/ ( ! ,pati5t ,protection & ,af=dable ,c>e ,act to ! ,f$]al ,gov]nm5t & to all ,/ates & t]ritories4 7b7 ,report ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,inspector ,g5]al ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices & ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all jo9tly submit a report to ,congress on ! results ( ! /udy conduct$ "u subsection 7a7 t includes ! in=mation specifi$ 9 p>agraphs 7#a7 ?r\gh 7#c7 ( t subsection1 toge!r ) su* recomm5dations = legislative or adm9i/rative action z ! ,inspector ,g5]al & ,comptroll] ,g5]al det]m9e appropriate4