[Federal Register Volume 64, Number 244 (Tuesday, December 21, 1999)]
[Rules and Regulations]
[Page 71317]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-32940]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of Inspector General

42 CFR Part 1001

RIN 0991-AA91


Federal Health Care Program: Fraud and Abuse; Statutory Exception 
to the Anti-Kickback Statute for Shared Risk Arrangements; Correction

AGENCY: Office of Inspector General (OIG), HHS.

ACTION: Interim final rule with comment period; correction amendment.

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SUMMARY: This document contains corrections to the interim final 
regulations which were published in the Federal Register on Friday, 
November 19, 1999 (64 FR 63504). These regulations established two new 
safe harbors from the anti-kickback statute (section 1128B(b) of the 
Social Security Act) to provide protection for certain managed care 
arrangements. A number of inadvertent errors appeared in both the 
preamble and in the text of the regulations that warrant clarification 
or revision. As a result, we are setting forth these revisions in order 
to assure the technical correctness of that document and the 
regulations.

EFFECTIVE DATE: December 21, 1999.

FOR FURTHER INFORMATION CONTACT: Joel Schaer, (202) 619-0089, OIG 
Regulations Officer.

SUPPLEMENTARY INFORMATION: The HHS Office of Inspector General (OIG) 
issued interim final regulations on November 19, 1999 (64 FR 63504) 
that set forth two new safe harbors from the anti-kickback statute to 
provide protection for certain managed care arrangements. In that 
interim final rule, a number of inadvertent errors appeared in the 
preamble and in 42 CFR part 1001 which are now being corrected.
    In the preamble on page 63505, second column, an extra bullet point 
was inserted before the words ``Underwriters/National Association of 
Life Underwriters.'' As corrected, the eleventh bullet point appearing 
in column two should read as ``Independent Insurance Agents of America/
National Association of Health Underwriters/National Association of 
Life Underwriters.''
    On page 63507 of the preamble, in the third column, second 
paragraph, the reference to ``paragraph (1)(i)(A)(IV)'' should be 
corrected to read as ``paragraph (1)(i)(A)(4).'' Similarly, in the 
third paragraph on this page, the reference to 
``Sec. 1001.952(t)(1)(i)(A)(IV)'' should be corrected to read as 
``Sec. 1001.952(t)(i)(A)(4).''
    In the first column on page 63508, in the second full paragraph, 
line 15, the words ``or cost'' should be inserted after the words 
``programs on a fee-for-service.''
    On page 63511, in the first column, the first line of the first 
full paragraph, the regulatory reference ``Sec. 1001.965(u)(2)(i)(B)'' 
should be corrected to read as ``Sec. 1001.952(u)(1)(i)(B).'' In 
addition, in the third full paragraph in column one on the same page, 
on the fourth and fifth lines, the parenthetical phrase ``(paragraphs 
(u)(1)(i)(C)(I)-(III))'' is revised to read as ``(paragraphs 
(u)(1)(i)(C)(1)-(3)).'' Lastly, in the last paragraph in column one, 
the parenthetical reference ``(paragraph (u)(1)(i)(C)(IV))'' should be 
corrected to read as ``(paragraph (u)(1)(i)(C)(4)).''
    In addition, we are correcting the regulatory text that was set 
forth in Sec. 1001.952(t). In the regulations text on page 63513, 
Sec. 1001.952(t)(1)(i)(B) is amended by adding the words ``or cost'' 
after the words ``fee-for-service.'' In addition, in 
Sec. 1001.952(t)(1)(ii)(B), we are (1) adding the words ``for or'' 
after the phrase ``receives remuneration in return'' and (2) are adding 
the words ``or cost'' after the words ``fee-for-service.'' These words 
were inadvertent omitted in the November 19, 1999 interim final rule.

List of Subjects in 42 CFR Part 1001

    Administrative practice and procedure, Fraud, Grant programs--
health, Health facilities, Health professions, Maternal and child 
health, Medicaid, Medicare, Social Security.
    Accordingly, 42 CFR part 1001 is corrected by making the following 
correcting amendments:

PART 1001--PROGRAM INTEGRITY--MEDICARE AND STATE HEALTH CARE 
PROGRAMS

    1. The authority citation for part 1001 continues to read as 
follows:

    Authority: 42 U.S.C. 1302, 1320a-7, 1320a-7b, 1395u(j), 
1395y(d), 1395y(e), 1395cc(b)(2)(D), (E) and (F), and 1395hh; and 
sec. 2455, Pub. L. 103-355, 108 Stat. 3327 (31 U.S.C. 6101 note).

    2. Section 1001.952 is amended by republishing the introductory 
text, and by revising paragraphs (t)(1)(i)(B) and (t)(1)(ii)(B) to read 
as follows:


Sec. 1001.952  Exceptions.

    The following payment practices shall not be treated as a criminal 
offense under section 1128B of the Act and shall not serve as the basis 
for an exclusion:
* * * * *
    (t) Price reductions offered to eligible managed care 
organizations. * * *
    (1) * * *
    (i) * * *
    (B) In establishing the terms of the agreement, neither party gives 
or receives remuneration in return for or to induce the provision or 
acceptance of business (other than business covered by the agreement) 
for which payment may be made in whole or in part by a Federal health 
care program on a fee-for-service or cost basis.
* * * * *
    (ii) * * *
    (B) In establishing the terms of the agreement, neither party gives 
or receives remuneration in return for or to induce the provision or 
acceptance of business (other than business covered by the agreement) 
for which payment may be made in whole or in part by a Federal health 
care program on a fee-for-service or cost basis.
* * * * *

    Dated: December 14, 1999.
Joel Schaer,
OIG Regulations Officer.
[FR Doc. 99-32940 Filed 12-20-99; 8:45 am]
BILLING CODE 4152-01-P