which entity has jurisdiction over health care coverage providers

When that happens, CMS will work with the state to ensure an effective transition. Washington State Office of the Attorney General Past Cases (last visited Nov. 19, 2020), https://www.atg.wa.gov/past-cases. Compliance and Enforcement | CMS - Centers for Medicare & Medicaid Services lock Missouri 0000035052 00000 n Our business operates as a fund depository, and an issuing and paying agent for U.S. He represents clients in antitrust class action, consumer protection, and breach of contract litigations in federal and state court. An agency within the U.S. Department of Labor, 200 Constitution Ave NW 0000007980 00000 n lEm 3. Is my company covered by the Scheduling Moratorium for Veterans Affairs Health Benefits Program (VAHBP) Providers? 41 CFR 60-741.2(i)(4). California Senate Bill 977 (SB 977), proposed earlier this year, required written notification to and the consent of the states attorney general before consummation for most healthcare affiliations or change of control transactions.2 Under SB 977, the attorney general would be required to deny consent for transactions that would not lead to (a) clinical integration or (b) the increase or maintenance of access to healthcare in underserved populations. ERISA | U.S. Department of Labor - DOL The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. which entity has jurisdiction over health care coverage providers 131E-176 (13) that has an electronic health Covered Entities for purposes of HIPAA include health care providers who submit claims using electronic "standard transactions" as well as health plans and health care clearinghouses. It is not intended as a form of, or as a substitute for legal advice. Californias proposed bill recently died in the legislature, but a new or similar version is likely to be introduced next year. 14-168(c) (2014). For guidance on this topic, please consult OFCCPs FAQs on the Single Entity Test at https://www.dol.gov/agencies/ofccp/faqs/single-entity-test. Brouse McDowell, A Legal Professional Association. 0000001958 00000 n Moreover, SB 977 not only would have applied to transactions among non-profit healthcare entities but also to acquisitions and affiliations by private equity groups and hedge funds with healthcare investments. How the proposed transaction affects competition. Whether a state in which a party to the transaction is located or does business has any notification obligations. Although specifics regarding the content of the notice were not provided in SB 977, the bill did state that the notice should contain information sufficient for the attorney general to assess the nature of the transaction and whether it will lead to clinical integration or an increase or maintenance of access to underserved populations.23 Once the notice was received, the attorney general would have 60 days to consent to the transaction, grant a waiver, or issue a request for additional information from the parties. 0000016173 00000 n For example, Washingtons reporting statute requires that the notice be submitted 60 days prior to close, which is 30 days longer than the federal HSR waiting period. .gov Accordingly, a hospital or other health care provider is not covered under the laws enforced by OFCCP if its only relationship with the Federal government is as a participating provider under Medicare Parts A and B and Medicaid. Which of the following does the California Department of Insurance (CDI) have NO jurisdiction over? Generally speaking, any business or organization that: Yes, if the contracts meet the threshold for coverage.