Health Care Exchanges Not Covered Under False Claims Act or Anti-Kick Back Statutes

Today Senator Chuck Grassley questioned Health and Human Services Secretary Kathleen Sebelius regarding the Obama Administration’s position that qualified health plans and other programs related to the federally facilitated marketplace and other programs under the Affordable Care Act are not considered federal health care programs.  This questioning is extremely important because under Sebelius’ interpretation many programs may be exempted from important anti-fraud laws.

Grassley questioned whether that would mean Obamacare programs are not subject to federal anti-kickback statutes and the federal False Claims Act, one of the government’s most effective tools against fraud, especially health care fraud in recent years.

“I’m alarmed that the Obama administration doesn’t understand the capacity for fraud in the new health care program,” Grassley said.  “The head of the agency in charge doesn’t seem to appreciate that the billions of dollars in subsidies for individuals going to health insurers to join Obamacare are federal tax dollars.  Those dollars should be subject to anti-fraud laws.  Why wouldn’t they be?”

"It is imperative that the anti-fraud provisions of the False Claims Act apply to all federal monies paid under Obama Care,” said Stephen Kohn, Executive Director of the National Whistleblower Center.  He continued, “HHS’ decision to exclude certain companies participating in the Obama Care program from federal anti-kickback laws will cost the taxpayers billions of dollars.  I hope this was a mistake, and not the result of a back room deal with lobbyists for the medical industry." 

See Strategic Move Exempts Health Law From Broader U.S. Statute.

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