Debate Over Categorizing Qualified Health Plans Continues

Law360, New York (April 30, 2014, 1:56 PM EDT) -- On Aug. 6, 2013, Rep. Jim McDermott, D-Wash., wrote a letter to Secretary of Health and Human Services Kathleen Sebelius asking whether qualified health plans (QHPs) on the new health insurance exchanges were considered federal health care programs. At stake was whether third parties, like pharmaceutical companies, could help pay enrollees' co-payments or other cost-sharing obligations — a practice that can implicate the federal Anti-Kickback Statute when federal health care programs, such as Medicare and Medicaid, are involved.[1]

On Oct. 30, 2013, Secretary Kathleen Sebelius responded with a letter to Rep. McDermott stating that HHS, after consultation with the U.S. Department...

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