0936-AA04 201610 The Regulatory Plan and the Unified Agenda of Federal Regulatory and Deregulatory Actions 0936 Office of the Inspector General OIG 0900 Department of Health and Human Services HHS Medicare and State Health Care Programs: Fraud and Abuse; Revisions to the Office of the Inspector General's Civil Monetary Penalty Rules

This rule makes changes to the Civil Monetary (CMPL) regulations at 42 CFR 1003 to implement authorities under the Affordable Care Act (ACA) and other statutes. ACA provides for CMS, assessments and exclusions for: (1) Failure to grant timely access to OIG; (2) Ordering and prescribing while excluded; (3) Making false statements, omissions or misrepresentations in an enrollment application; (4) Failure to return an overpayment; and (5) Making or using a false record or statement that is material to a false or fradulent claim. We also finalize a reorganization of 42 CFR 1003 to make the regulations more accessible to the public, and to add clarity to the regulatory scheme. We finalize an alternate methodology for calculating penalties and assessments for employing excluded individuals in the liability guidelines under OIG authorities, including the CMPL, the Emergency Medical Treatment and Labor Act; section 1140 of the Social Security Act for conduct involving electronic mail, Internet, and telemarketing solicitations and section 1927 of the Social Security Act for late or incomplete reporting of drug pricing information.

 

]]> Other Significant Previously Published in The Unified Agenda Final Rule Stage No No 42 CFR 1003 42 CFR 1005 42 U.S.C. 262a 42 U.S.C. 405(a) 42 U.S.C. 405(b) 42 U.S.C. 1302 42 U.S.C. 1320a–7 42 U.S.C. 1320a-7a 42 U.S.C. 1320a-7(c) 42 U.S.C. 1320b-10 42 U.S.C. 1320c–5 42 U.S.C. 1395dd(d)(1) 42 U.S.C. 1395mm 42 U.S.C. 1395nn(g) 42 U.S.C. 1395ss(d) 42 U.S.C. 1395w-112(b)(3)(E) 42 U.S.C. 1395w-141(i)(3) 42 U.S.C. 1395w-27(g) 42 U.S.C. 1395y(b)(3)(B) 42 U.S.C. 1396b(m) 42 U.S.C. 1396r-7(b)(3)(B) 42 U.S.C. 1396r-7(b)(3)(C) 42 U.S.C. 1396t(i)(3) 42 U.S.C. 11131c 42 U.S.C. 11137(b)(2) No NPRM 05/12/2014 79 FR 27079 NPRM Comment Period End 07/11/2014 Final Action 11/00/2016 No No None No No No No Katie Arnholt 0936 Office of the Inspector General OIG 202 619-0335 DC 20201 Patrice Drew S. Regulations Analyst 0936 Office of the Inspector General OIG 202 619-1368 patrice.drew@oig.hhs.gov 330 Independence Avenue SW., Washington DC 20201