Solicitation of New Safe Harbors and Special Fraud Alerts, 78376-78378 [2014-30156]
Download as PDF
78376
Federal Register / Vol. 79, No. 249 / Tuesday, December 30, 2014 / Proposed Rules
Division 264: Rules for Open Burning
The revisions to OAR Chapter 340,
Division 264 enhance the open burning
rule in Oregon and the Klamath Falls
NAA. Specifically, the revised rule
includes language aligning open
burning with ideal dispersion
conditions; provides a description and
map of the Klamath Basin Open Burning
Control Area; and provides rules
specific to the Klamath Falls NAA
prohibiting open burning from
industrial, commercial, construction
and demolition operations. The rule
revisions will reduce emissions through
the prohibition of open burning within
the Klamath Falls NAA. The EPA
proposes to approve and IBR these rule
revisions because they are permanent
and enforceable measures that support
attainment and maintenance of the
NAAQS by reducing the amount of
particulate matter in the area.
tkelley on DSK3SPTVN1PROD with PROPOSALS
Klamath County Clean Air Ordinances
In its December 12, 2012 submittal,
the ODEQ included as control measures
the 2007 and 2012 Klamath County
Clean Air Ordinances. These two
ordinances establish permanent and
enforceable control measures on sources
that account for the majority of PM2.5
emissions in the Klamath Falls NAA.
The 2007 Klamath County Clean Air
Ordinance is more specifically
identified as Chapter 406, Ordinance
No. 63.05, enacted August 7, 2007 (2007
Ordinance). The 2012 Klamath County
Clean Air Ordinance is more
specifically identified as Chapter 406,
Ordinance No. 63.06, enacted December
31, 2012 (2012 Ordinance).
The 2007 and 2012 Ordinances were
enacted to control emissions from home
heating devices for the purpose of
meeting the 2006 PM2.5 24-hr NAAQS.
The 2007 ordinance provides for lower
thresholds for yellow and red air quality
advisory days which require the
curtailment of wood burning and
therefore reduce emissions of PM2.5 and
PM2.5 precursors. With these lower
thresholds, wood burning restrictions
would be in place on days that most
likely contribute to a 24-hour NAAQS
violation. This provision, in conjunction
with increased enforcement at the
County level, is expected to be a core
part of the area’s attainment plan. The
2007 ordinance has provisions identical
to the state wide Heat Smart Program
that require removal of uncertified
stoves upon sale of a home, and also
provisions that reduce the number of
available residential open burning days
and prohibit the use of burn barrels. The
2012 ordinance required new and
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retrofit fireplaces to meet lower
emissions standards.
The EPA proposes to approve and IBR
the 2007 and 2012 Klamath Falls Clean
Air Ordinances because they support
attainment and maintenance of the
NAAQS in the Klamath Falls NAA.
III. Proposed Action
The EPA proposes to approve the
PM2.5 and PM2.5 precursor emissions
inventory for the Klamath Falls NAA,
submitted by ODEQ on December 12,
2012, as meeting the emissions
inventory requirements of section
172(c)(3) of the CAA for 2006 PM2.5 24hr NAAQS nonattainment area
planning. The EPA also proposes to
approve and incorporate into the SIP the
specific control measures submitted by
the ODEQ on December 12, 2012, to the
extent set forth in this notice. These
control measures are described in this
action and are included in the docket
for this proposed action. If approved,
these specific control measures would
become part of the Oregon SIP. The EPA
is not taking action on certain aspects of
the revisions submitted by the ODEQ.
The EPA expects to take action on the
remaining SIP revisions and any
additional revisions that may be
submitted by the ODEQ in the future.
IV. Statutory and Executive Order
Reviews
Under the CAA, the Administrator is
required to approve a SIP submission
that complies with the provisions of the
CAA and applicable federal regulations.
42 U.S.C. 7410(k); 40 CFR 52.02(a).
Thus, in reviewing SIP submissions, the
EPA’s role is to approve state choices,
provided that they meet the criteria of
the CAA. Accordingly, this action
merely proposes to approve state law as
meeting federal requirements and does
not impose additional requirements
beyond those imposed by State law. For
that reason, this proposed action:
• Is not a ‘‘significant regulatory
action’’ subject to review by the Office
of Management and Budget under
Executive Order 12866 (58 FR 51735,
October 4, 1993);
• Does not impose an information
collection burden under the provisions
of the Paperwork Reduction Act (44
U.S.C. 3501 et seq.);
• Is certified as not having a
significant economic impact on a
substantial number of small entities
under the Regulatory Flexibility Act (5
U.S.C. 601 et seq.);
• Does not contain any unfunded
mandate or significantly or uniquely
affect small governments, as described
in the Unfunded Mandates Reform Act
of 1995 (Pub. L. 104–4);
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Fmt 4702
Sfmt 4702
• Does not have federalism
implications as specified in Executive
Order 13132 (64 FR 43255, August 10,
1999);
• Is not an economically significant
regulatory action based on health or
safety risks subject to Executive Order
13045 (62 FR 19885, April 23, 1997);
• Is not a significant regulatory action
subject to Executive Order 13211 (66 FR
28355, May 22, 2001);
• Is not subject to requirements of
Section 12(d) of the National
Technology Transfer and Advancement
Act of 1995 (15 U.S.C. 272 note) because
application of those requirements would
be inconsistent with the CAA; and
• Does not provide the EPA with the
discretionary authority to address, as
appropriate, disproportionate human
health or environmental effects, using
practicable and legally permissible
methods, under Executive Order 12898
(59 FR 7629, February 16, 1994).
In addition, this SIP is not approved to
apply on any Indian reservation land or
in any other area where EPA or an
Indian tribe has demonstrated that a
tribe has jurisdiction. In those areas of
Indian country, the rule does not have
tribal implications as specified by
Executive Order 13175 (65 FR 67249,
November 9, 2000), nor will it impose
substantial direct costs on tribal
governments or preempt tribal law.
List of Subjects in 40 CFR Part 52
Environmental protection, Air
pollution control, Nitrogen dioxide,
Incorporation by reference, Particulate
matter, Reporting and recordkeeping
requirements, Sulfur oxides, Volatile
organic compounds.
Authority: 42 U.S.C. 7401 et seq.
Dated: December 3, 2014.
Dennis J. McLerran,
Regional Administrator, Region 10.
[FR Doc. 2014–30498 Filed 12–29–14; 8:45 am]
BILLING CODE 6560–50–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Office of Inspector General
42 CFR Part 1001
Solicitation of New Safe Harbors and
Special Fraud Alerts
Office of Inspector General
(OIG), HHS.
ACTION: Notice of intent to develop
regulations.
AGENCY:
In accordance with section
205 of the Health Insurance Portability
SUMMARY:
E:\FR\FM\30DEP1.SGM
30DEP1
tkelley on DSK3SPTVN1PROD with PROPOSALS
Federal Register / Vol. 79, No. 249 / Tuesday, December 30, 2014 / Proposed Rules
and Accountability Act of 1996
(HIPAA), this annual notice solicits
proposals and recommendations for
developing new and modifying existing
safe harbor provisions under the Federal
anti-kickback statute (section 1128B(b)
of the Social Security Act), as well as
developing new OIG Special Fraud
Alerts.
DATES: To ensure consideration, public
comments must be delivered to the
address provided below by no later than
5 p.m. on March 2, 2015.
ADDRESSES: In commenting, please refer
to file code OIG–123–N. Because of staff
and resource limitations, we cannot
accept comments by facsimile (fax)
transmission.
You may submit comments in one of
three ways (no duplicates, please):
1. Electronically. You may submit
electronic comments on specific
recommendations and proposals
through the Federal eRulemaking Portal
at https://www.regulations.gov.
2. By regular, express, or overnight
mail. You may send written comments
to the following address: Patrice Drew,
Office of Inspector General, Regulatory
Affairs, Department of Health and
Human Services, Attention: OIG–123–N,
Room 5541C, Cohen Building, 330
Independence Avenue SW.,
Washington, DC 20201. Please allow
sufficient time for mailed comments to
be received before the close of the
comment period.
3. By hand or courier. If you prefer,
you may deliver, by hand or courier,
your written comments before the close
of the comment period to Patrice Drew,
Office of Inspector General, Department
of Health and Human Services, Cohen
Building, Room 5541C, 330
Independence Avenue SW.,
Washington, DC 20201. Because access
to the interior of the Cohen Building is
not readily available to persons without
Federal Government identification,
commenters are encouraged to schedule
their delivery with one of our staff
members at (202) 619–1368.
For information on viewing public
comments, please see the
SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT:
Patrice Drew, Congressional and
Regulatory Affairs Liaison, Office of
Inspector General, (202) 619–1368.
SUPPLEMENTARY INFORMATION:
Submitting Comments: We welcome
comments from the public on
recommendations for developing new or
revised safe harbors and Special Fraud
Alerts. Please assist us by referencing
the file code OIG–123–N.
Inspection of Public Comments: All
comments received before the end of the
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17:03 Dec 29, 2014
Jkt 235001
comment period are available for
viewing by the public. All comments
will be posted on https://
www.regulations.gov after the closing of
the comment period. Comments
received timely will also be available for
public inspection as they are received at
Office of Inspector General, Department
of Health and Human Services, Cohen
Building, 330 Independence Avenue
SW., Washington, DC 20201, Monday
through Friday from 9:30 a.m. to 5 p.m.
To schedule an appointment to view
public comments, phone (202) 619–
1368.
I. Background
A. OIG Safe Harbor Provisions
Section 1128B(b) of the Social
Security Act (the Act) (42 U.S.C. 1320a–
7b(b)) provides criminal penalties for
individuals or entities that knowingly
and willfully offer, pay, solicit, or
receive remuneration to induce or
reward business reimbursable under the
Federal health care programs. The
offense is classified as a felony and is
punishable by fines of up to $25,000
and imprisonment for up to 5 years. OIG
may also impose civil money penalties,
in accordance with section 1128A(a)(7)
of the Act (42 U.S.C. 1320a–7a(a)(7)), or
exclusion from the Federal health care
programs, in accordance with section
1128(b)(7) of the Act (42 U.S.C. 1320a–
7(b)(7)).
Since the statute on its face is so
broad, concern has been expressed for
many years that some relatively
innocuous commercial arrangements
may be subject to criminal prosecution
or administrative sanction. In response
to the above concern, section 14 of the
Medicare and Medicaid Patient and
Program Protection Act of 1987, P.L. No.
100–93, section 14, the Act, section
1128B(b), 42 U.S.C. 1320a–7b(b),
specifically required the development
and promulgation of regulations, the socalled ‘‘safe harbor’’ provisions,
specifying various payment and
business practices that, although
potentially capable of inducing referrals
of business reimbursable under the
Federal health care programs, would not
be treated as criminal offenses under the
anti-kickback statute and would not
serve as a basis for administrative
sanctions. OIG safe harbor provisions
have been developed ‘‘to limit the reach
of the statute somewhat by permitting
certain non-abusive arrangements, while
encouraging beneficial and innocuous
arrangements’’ (56 FR 35952, July 29,
1991). Health care providers and others
may voluntarily seek to comply with
these provisions so that they have the
assurance that their business practices
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78377
will not be subject to liability under the
anti-kickback statute or related
administrative authorities. The OIG safe
harbor regulations are found at 42 CFR
part 1001.
B. OIG Special Fraud Alerts
OIG has also periodically issued
Special Fraud Alerts to give continuing
guidance to health care providers with
respect to practices OIG finds
potentially fraudulent or abusive. The
Special Fraud Alerts encourage industry
compliance by giving providers
guidance that can be applied to their
own practices. OIG Special Fraud Alerts
are intended for extensive distribution
directly to the health care provider
community, as well as to those charged
with administering the Federal health
care programs.
In developing Special Fraud Alerts,
OIG has relied on a number of sources
and has consulted directly with experts
in the subject field, including those
within OIG, other agencies of the
Department, other Federal and State
agencies, and those in the health care
industry.
C. Section 205 of the Health Insurance
Portability and Accountability Act of
1996
Section 205 of the Health Insurance
Portability and Accountability Act of
1996 (HIPAA), Public Law 104–191,
section 205, the Act, section 1128D, 42
U.S.C. 1320a-7d, requires the
Department to develop and publish an
annual notice in the Federal Register
formally soliciting proposals for
modifying existing safe harbors to the
anti-kickback statute and for developing
new safe harbors and Special Fraud
Alerts.
In developing safe harbors for a
criminal statute, OIG is required to
thoroughly review the range of factual
circumstances that may fall within the
proposed safe harbor subject area so as
to uncover potential opportunities for
fraud and abuse. Only then can OIG
determine, in consultation with the
Department of Justice, whether it can
effectively develop regulatory
limitations and controls that will permit
beneficial and innocuous arrangements
within a subject area while, at the same
time, protecting the Federal health care
programs and their beneficiaries from
abusive practices.
II. Solicitation of Additional New
Recommendations and Proposals
In accordance with the requirements
of section 205 of HIPAA, OIG last
published a Federal Register
solicitation notice for developing new
safe harbors and Special Fraud Alerts on
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78378
Federal Register / Vol. 79, No. 249 / Tuesday, December 30, 2014 / Proposed Rules
December 27, 2013 (78 FR 78807). As
required under section 205, a status
report of the public comments related to
safe harbors received in response to that
notice is set forth in Appendix F of
OIG’s Fall 2014 Semiannual Report.1
OIG is not seeking additional public
comment on the proposals listed in
Appendix F at this time. Rather, this
notice seeks additional
recommendations regarding the
development of new or modified safe
harbor regulations and new Special
Fraud Alerts beyond those summarized
in Appendix F.
A detailed explanation of
justifications for, or empirical data
supporting, a suggestion for a safe
harbor or Special Fraud Alert would be
helpful and should, if possible, be
included in any response to this
solicitation.
A. Criteria for Modifying and
Establishing Safe Harbor Provisions
In accordance with section 205 of
HIPAA, we will consider a number of
factors in reviewing proposals for new
or modified safe harbor provisions, such
as the extent to which the proposals
would affect an increase or decrease in:
• Access to health care services,
• the quality of health care services,
• patient freedom of choice among
health care providers,
• competition among health care
providers,
• the cost to Federal health care
programs,
• the potential overutilization of
health care services, and
• the ability of health care facilities to
provide services in medically
underserved areas or to medically
underserved populations.
In addition, we will also consider
other factors, including, for example,
the existence (or nonexistence) of any
potential financial benefit to health care
professionals or providers that may take
into account their decisions whether to
(1) order a health care item or service or
(2) arrange for a referral of health care
items or services to a particular
practitioner or provider.
tkelley on DSK3SPTVN1PROD with PROPOSALS
B. Criteria for Developing Special Fraud
Alerts
In determining whether to issue
additional Special Fraud Alerts, we will
consider whether, and to what extent,
the practices that would be identified in
a new Special Fraud Alert may result in
any of the consequences set forth above,
as well as the volume and frequency of
1 The OIG Semiannual Report to Congress can be
accessed through the OIG Web site at https://
oig.hhs.gov/publications/semiannual.asp.
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Jkt 235001
the conduct that would be identified in
the Special Fraud Alert.
Dated: December 18, 2014.
Daniel R. Levinson,
Inspector General.
[FR Doc. 2014–30156 Filed 12–29–14; 8:45 am]
BILLING CODE 4152–01–P
DEPARTMENT OF DEFENSE
GENERAL SERVICES
ADMINISTRATION
NATIONAL AERONAUTICS AND
SPACE ADMINISTRATION
48 CFR Part 6
[FAR Case 2014–020; Docket No. 2014–
0020; Sequence No. 1]
RIN 9000–AM86
Federal Acquisition Regulation;
Clarification on Justification for Urgent
Noncompetitive Awards Exceeding
One Year
Department of Defense (DoD),
General Services Administration (GSA),
and National Aeronautics and Space
Administration (NASA).
ACTION: Proposed rule.
AGENCY:
DoD, GSA, and NASA are
proposing to amend the Federal
Acquisition Regulation (FAR) to clarify
that a determination of exceptional
circumstances is needed when a
noncompetitive contract awarded on the
basis of unusual and compelling
urgency exceeds one year, either at time
of award or due to post-award
modifications.
SUMMARY:
Interested parties should submit
written comments to the Regulatory
Secretariat at one of the addresses
shown below on or before March 2,
2015 to be considered in the formation
of the final rule.
ADDRESSES: Submit comments in
response to FAR Case 2014–020 by any
of the following methods:
• Regulations.gov: https://
www.regulations.gov. Submit comments
via the Federal eRulemaking portal by
searching for ‘‘FAR Case 2014–020’’.
Select the link ‘‘Comment Now’’ that
corresponds with ‘‘FAR Case 2014–
020’’. Follow the instructions provided
at the ‘‘Comment Now’’ screen. Please
include your name, company name (if
any), and ‘‘FAR Case 2014–020’’ on your
attached document.
• Fax: 202–501–4067.
• Mail: General Services
Administration, Regulatory Secretariat
(MVCB), ATTN: Ms. Flowers, 1800 F
DATES:
PO 00000
Frm 00065
Fmt 4702
Sfmt 4702
Street NW., 2nd Floor, Washington, DC
20405.
Instructions: Please submit comments
only and cite FAR Case 2014–020, in all
correspondence related to this case. All
comments received will be posted
without change to https://
www.regulations.gov, including any
personal and/or business confidential
information provided.
FOR FURTHER INFORMATION CONTACT: Mr.
Michael O. Jackson, Procurement
Analyst, at 202–208–4949, for
clarification of content. For information
pertaining to status or publication
schedules, contact the Regulatory
Secretariat at 202–501–4755. Please cite
FAR Case 2014–020.
SUPPLEMENTARY INFORMATION:
I. Background
DoD, GSA, and NASA are revising the
FAR in response to a Government
Accountability Office (GAO) report,
GAO–14–304, Federal Contracting:
Noncompetitive Contracts Based on
Urgency Need Additional Oversight,
dated March 2014. On October 14, 2009,
the FAR was amended to implement
section 862 of the Duncan Hunter
National Defense Authorization Act
(NDAA) for Fiscal Year (FY) 2009 (Pub.
L. 110–417) which restricted the length
of contracts awarded noncompetitively
under unusual and compelling urgency
circumstances. Such contracts may not
exceed one year unless the head of the
executive agency determines that
exceptional circumstances apply.
GAO found that agencies did not
make the required determination for the
ten contracts in GAO’s sample that had
a period of performance of more than
one year. As a result, GAO
recommended that DoD, U.S.
Department of State and U.S. Agency for
International Development provide
guidance to improve data reliability and
oversight for contracts awarded using
the urgency exception.
Additionally, GAO recommended that
the Director of the Office of
Management and Budget, through the
Office of Federal Procurement Policy,
provide guidance to clarify when
determinations of exceptional
circumstances are needed when a
noncompetitive contract awarded on the
basis of unusual and compelling
urgency exceeds one year, either at the
time of award or because it was
modified after contract award.
This rule clarifies that a
determination of exceptional
circumstances is needed whenever the
period of performance of a
noncompetitive contract awarded on the
basis of unusual and compelling
urgency is extended beyond a year.
E:\FR\FM\30DEP1.SGM
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Agencies
[Federal Register Volume 79, Number 249 (Tuesday, December 30, 2014)]
[Proposed Rules]
[Pages 78376-78378]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-30156]
=======================================================================
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of Inspector General
42 CFR Part 1001
Solicitation of New Safe Harbors and Special Fraud Alerts
AGENCY: Office of Inspector General (OIG), HHS.
ACTION: Notice of intent to develop regulations.
-----------------------------------------------------------------------
SUMMARY: In accordance with section 205 of the Health Insurance
Portability
[[Page 78377]]
and Accountability Act of 1996 (HIPAA), this annual notice solicits
proposals and recommendations for developing new and modifying existing
safe harbor provisions under the Federal anti-kickback statute (section
1128B(b) of the Social Security Act), as well as developing new OIG
Special Fraud Alerts.
DATES: To ensure consideration, public comments must be delivered to
the address provided below by no later than 5 p.m. on March 2, 2015.
ADDRESSES: In commenting, please refer to file code OIG-123-N. Because
of staff and resource limitations, we cannot accept comments by
facsimile (fax) transmission.
You may submit comments in one of three ways (no duplicates,
please):
1. Electronically. You may submit electronic comments on specific
recommendations and proposals through the Federal eRulemaking Portal at
https://www.regulations.gov.
2. By regular, express, or overnight mail. You may send written
comments to the following address: Patrice Drew, Office of Inspector
General, Regulatory Affairs, Department of Health and Human Services,
Attention: OIG-123-N, Room 5541C, Cohen Building, 330 Independence
Avenue SW., Washington, DC 20201. Please allow sufficient time for
mailed comments to be received before the close of the comment period.
3. By hand or courier. If you prefer, you may deliver, by hand or
courier, your written comments before the close of the comment period
to Patrice Drew, Office of Inspector General, Department of Health and
Human Services, Cohen Building, Room 5541C, 330 Independence Avenue
SW., Washington, DC 20201. Because access to the interior of the Cohen
Building is not readily available to persons without Federal Government
identification, commenters are encouraged to schedule their delivery
with one of our staff members at (202) 619-1368.
For information on viewing public comments, please see the
SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT: Patrice Drew, Congressional and
Regulatory Affairs Liaison, Office of Inspector General, (202) 619-
1368.
SUPPLEMENTARY INFORMATION:
Submitting Comments: We welcome comments from the public on
recommendations for developing new or revised safe harbors and Special
Fraud Alerts. Please assist us by referencing the file code OIG-123-N.
Inspection of Public Comments: All comments received before the end
of the comment period are available for viewing by the public. All
comments will be posted on https://www.regulations.gov after the closing
of the comment period. Comments received timely will also be available
for public inspection as they are received at Office of Inspector
General, Department of Health and Human Services, Cohen Building, 330
Independence Avenue SW., Washington, DC 20201, Monday through Friday
from 9:30 a.m. to 5 p.m. To schedule an appointment to view public
comments, phone (202) 619-1368.
I. Background
A. OIG Safe Harbor Provisions
Section 1128B(b) of the Social Security Act (the Act) (42 U.S.C.
1320a-7b(b)) provides criminal penalties for individuals or entities
that knowingly and willfully offer, pay, solicit, or receive
remuneration to induce or reward business reimbursable under the
Federal health care programs. The offense is classified as a felony and
is punishable by fines of up to $25,000 and imprisonment for up to 5
years. OIG may also impose civil money penalties, in accordance with
section 1128A(a)(7) of the Act (42 U.S.C. 1320a-7a(a)(7)), or exclusion
from the Federal health care programs, in accordance with section
1128(b)(7) of the Act (42 U.S.C. 1320a-7(b)(7)).
Since the statute on its face is so broad, concern has been
expressed for many years that some relatively innocuous commercial
arrangements may be subject to criminal prosecution or administrative
sanction. In response to the above concern, section 14 of the Medicare
and Medicaid Patient and Program Protection Act of 1987, P.L. No. 100-
93, section 14, the Act, section 1128B(b), 42 U.S.C. 1320a-7b(b),
specifically required the development and promulgation of regulations,
the so-called ``safe harbor'' provisions, specifying various payment
and business practices that, although potentially capable of inducing
referrals of business reimbursable under the Federal health care
programs, would not be treated as criminal offenses under the anti-
kickback statute and would not serve as a basis for administrative
sanctions. OIG safe harbor provisions have been developed ``to limit
the reach of the statute somewhat by permitting certain non-abusive
arrangements, while encouraging beneficial and innocuous arrangements''
(56 FR 35952, July 29, 1991). Health care providers and others may
voluntarily seek to comply with these provisions so that they have the
assurance that their business practices will not be subject to
liability under the anti-kickback statute or related administrative
authorities. The OIG safe harbor regulations are found at 42 CFR part
1001.
B. OIG Special Fraud Alerts
OIG has also periodically issued Special Fraud Alerts to give
continuing guidance to health care providers with respect to practices
OIG finds potentially fraudulent or abusive. The Special Fraud Alerts
encourage industry compliance by giving providers guidance that can be
applied to their own practices. OIG Special Fraud Alerts are intended
for extensive distribution directly to the health care provider
community, as well as to those charged with administering the Federal
health care programs.
In developing Special Fraud Alerts, OIG has relied on a number of
sources and has consulted directly with experts in the subject field,
including those within OIG, other agencies of the Department, other
Federal and State agencies, and those in the health care industry.
C. Section 205 of the Health Insurance Portability and Accountability
Act of 1996
Section 205 of the Health Insurance Portability and Accountability
Act of 1996 (HIPAA), Public Law 104-191, section 205, the Act, section
1128D, 42 U.S.C. 1320a-7d, requires the Department to develop and
publish an annual notice in the Federal Register formally soliciting
proposals for modifying existing safe harbors to the anti-kickback
statute and for developing new safe harbors and Special Fraud Alerts.
In developing safe harbors for a criminal statute, OIG is required
to thoroughly review the range of factual circumstances that may fall
within the proposed safe harbor subject area so as to uncover potential
opportunities for fraud and abuse. Only then can OIG determine, in
consultation with the Department of Justice, whether it can effectively
develop regulatory limitations and controls that will permit beneficial
and innocuous arrangements within a subject area while, at the same
time, protecting the Federal health care programs and their
beneficiaries from abusive practices.
II. Solicitation of Additional New Recommendations and Proposals
In accordance with the requirements of section 205 of HIPAA, OIG
last published a Federal Register solicitation notice for developing
new safe harbors and Special Fraud Alerts on
[[Page 78378]]
December 27, 2013 (78 FR 78807). As required under section 205, a
status report of the public comments related to safe harbors received
in response to that notice is set forth in Appendix F of OIG's Fall
2014 Semiannual Report.\1\ OIG is not seeking additional public comment
on the proposals listed in Appendix F at this time. Rather, this notice
seeks additional recommendations regarding the development of new or
modified safe harbor regulations and new Special Fraud Alerts beyond
those summarized in Appendix F.
---------------------------------------------------------------------------
\1\ The OIG Semiannual Report to Congress can be accessed
through the OIG Web site at https://oig.hhs.gov/publications/semiannual.asp.
---------------------------------------------------------------------------
A detailed explanation of justifications for, or empirical data
supporting, a suggestion for a safe harbor or Special Fraud Alert would
be helpful and should, if possible, be included in any response to this
solicitation.
A. Criteria for Modifying and Establishing Safe Harbor Provisions
In accordance with section 205 of HIPAA, we will consider a number
of factors in reviewing proposals for new or modified safe harbor
provisions, such as the extent to which the proposals would affect an
increase or decrease in:
Access to health care services,
the quality of health care services,
patient freedom of choice among health care providers,
competition among health care providers,
the cost to Federal health care programs,
the potential overutilization of health care services, and
the ability of health care facilities to provide services
in medically underserved areas or to medically underserved populations.
In addition, we will also consider other factors, including, for
example, the existence (or nonexistence) of any potential financial
benefit to health care professionals or providers that may take into
account their decisions whether to (1) order a health care item or
service or (2) arrange for a referral of health care items or services
to a particular practitioner or provider.
B. Criteria for Developing Special Fraud Alerts
In determining whether to issue additional Special Fraud Alerts, we
will consider whether, and to what extent, the practices that would be
identified in a new Special Fraud Alert may result in any of the
consequences set forth above, as well as the volume and frequency of
the conduct that would be identified in the Special Fraud Alert.
Dated: December 18, 2014.
Daniel R. Levinson,
Inspector General.
[FR Doc. 2014-30156 Filed 12-29-14; 8:45 am]
BILLING CODE 4152-01-P