No, an insurance company that supplies workers compensation insurance to a federal contractor does not need to meet the requirements of Executive Order 11246; however, if such insurance company has a separate covered federal contract or subcontract other than providing worker compensation insurance, they may be subjected to the requirements of Executive Order 11246. This strategy must be considered carefully, but can be beneficial depending on the acquiring providers risk tolerance, market concentration, and the extent and number of competitive overlaps between the affiliating providers. For covered insurance contracts, does OFCCP use the insurance premium or the face value of the policy to determine whether a federal contractor is required to develop and maintain an Executive Order 11246 affirmative action plan (AAP)? 0000015627 00000 n Federal government websites often end in .gov or .mil. What entities are subject to the requirements of Executive Order 11246? Recent Changes to the Definition of Sex Discrimination Under Section 1557 of the Patient Protection and Affordable Care Act, Eleventh Circuit Holds that the Government Need Not Prove a Payees Motivation for Accepting a Payment Under the Anti-Kickback Statute, Representations and Warranties Insurance: An Essential Component of Healthcare Mergers and Acquisitions, American Bar Association .manual-search ul.usa-list li {max-width:100%;} COVERED CALIFORNIANS Accordingly, if your business or organization became a fund depository or an issuing and paying agent for savings bonds and notes on or after December 1, 2003, it would also be subject to the written AAP requirement under VEVRAA if the contract is for $150,000 or more. https://www.dol.gov/agencies/ofccp/faqs/single-entity-test, Scheduling Moratorium for VAHBP Providers. Title XXVII of the Public Health Service Act (PHS Act) contemplates that states will exercise primary enforcement authority over health insurance issuers in the group and individual markets to ensure compliance with health insurance market reforms. Further, the VAHBP Moratorium is not a complete exclusion from OFCCPs authority as it only relieves an entity from being neutrally scheduled for a compliance evaluation. Sign up to get the latest information about your choice of CMS topics. 0000013829 00000 n ) If a request for additional information was issued, then the attorney general had 45 days from substantial compliance with the request to grant or deny approval of the transaction. Washington State Office of the Attorney General Past Cases (last visited Nov. 19, 2020), https://www.atg.wa.gov/past-cases. Although the proposed amendments to New Yorks Donnelly Act are not limited in application to the healthcare industry, the contemplated abuse of dominance provision could present significant increased enforcement risk for healthcare providers. 0000008002 00000 n As part of its contract with the plan and typically required by state law, the in-network provider agrees not to charge the plan or enrollee more than the negotiated rate. Are we subject to the equal employment laws enforced by OFCCP? How long must a policy be in force before an insurer is prohibited from denying claims based on misstatements made on the health policy application? -Long-term care is covered by Medicare Part C. -Hospice is covered by Medicare Part A. Based on the difference between the new and original policy annual premiums: Before an insurer is allowed to test an individual for HIV, what must be completed . 0000001401 00000 n The amendments proposed to the Donnelly Act, if enacted, would dramatically expand the reach of New Yorks state antitrust laws and the ability of the attorney general to pursue claims under state law that it previously was only able to bring under federal law. Overseeing the insurance industry and protecting the state's insurance consumers is the responsibility of the California Department of Insurance (CDI). Before sharing sensitive information, make sure youre on a federal government site. 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. These states can then use the information gathered from these notifications for their investigative and enforcement functions possibly challenging the transactions. The legislation only applies to mergers commenced on or after the applicable effective date of this act.31 No. 14-168(c) (2014). It's time to renew your membership and keep access to free CLE, valuable publications and more. The South Carolina Lifeand Accident and Health Insurance Guaranty Association(SCLAHIGA) may cover certain direct life insurance policies, accident and health insurance policies, annuity contracts, and contracts supplemental to life, accident, and health insurance policiesand contracts under South Carolina law. Nonetheless, OFCCP has not conceded jurisdiction over healthcare providers that participate in TRICARE and FEHBP networks. Like the Executive Order regulations, these regulations also state that the term "nonpersonal services" includes, but is not limited to the following services: Therefore, financial institutions with federal share and deposit insurance are considered to be government contractors. Accordingly, non-Federal governmental plans are subject to the provisions of Part A of title XXVII of the PHS Act, including any changes made by the ACA. The Affordable Care Act made a number of changes, with the result that sponsors of self-funded, non-Federal governmental plans can no longer opt out of as many requirements of Title XXVII. The Patient Protection and Affordable Care Act, enacted on March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, enacted on March 30, 2010, (collectively known as the Affordable Care Act)(ACA) reorganized, amended, and added to the provisions of Part A of title XXVII of the PHS Act.
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