The Clinton administration hasn't given up on its goal of repealing federal fraud-and-abuse enforcement reforms held sacred by provider groups.
Administration officials last week renewed their call for repeal of the reforms, which were included in the Health Insurance Portability and Accountability Act of 1996, known as the Kassebaum-Kennedy insurance law.
Meanwhile, a source in HHS' inspector general's office said the rules implementing some of the fraud reforms will be out as scheduled by the end of this week (Sept. 2, 1996, p. 44).
In the White House's fiscal 1998 budget, the administration said it would save $300 million over five years by reversing three reforms.
The first measure would expand the exception to federal anti-kickback statutes for certain managed-care plans. The second would make it harder for federal gumshoes to prove fraud charges against providers. The third measure-the one most important to provider groups-would allow providers to request individual guidance to ensure that integrated systems are not running afoul of federal anti-kickback laws.
The laws bar any form of remuneration to induce the referral of Medicare or Medicaid business.
The administration argued that requiring the U.S. Justice Department and HHS to provide "advisory opinions" on individual business ventures will tax federal resources and may give providers umbrella legal protection for other illegal activities.
Last week, at a hearing of the Senate Labor and Human Resources Committee, HCFA Administrator Bruce Vladeck said the administration was considering rolling a number of fraud-and-abuse provisions into a bill separate from the budget.
But provider groups say they will fight any attempts by the White House to repeal the provisions.
"We would be violently opposed to that," said Thomas Scully, president of the Federation of American Health Systems. "Last year, we agreed to higher fines and tougher sanctions for fraud in exchange for some definition in what violated the rules. Now the (HHS inspector general) is coming along and saying they want to wipe that out."