42 C.F.R. § 1001.952 - Exceptions

Cite as42 C.F.R. § 1001.952
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482 practice notes
  • Securing Updated and Necessary Statutory Evaluations Timely
    • United States
    • Centers For Medicare And Medicaid Services,Public Health Service,The Inspector General Office
    • Invalid date
    ...(OIG), which is a component of HHS, although certain regulations for which OIG has enforcement responsibility are exempt, such as 42 CFR 1001.952. For regulations that were issued in coordination with another Agency, that function in concert with another Agency's regulations, or that have a......
  • Klaczak v. Consolidated Medical Transport, No. 96 C 6502.
    • United States
    • United States District Courts. 7th Circuit. United States District Court (Northern District of Illinois)
    • September 30, 2006
    ...rate—it states that a reduction in price does not qualify as a discount if it is not offered to "Medicare or Medicaid." 42 C.F.R. 1001.952(h). Thus, again, on the record assembled, Relators have not established or explained any reasonable basis for concluding that a discount below......
  • United States v. Marder, Case No. 1:13-cv-24503-KMM
    • United States
    • United States District Courts. 11th Circuit. United States District Courts. 11th Circuit. Southern District of Florida
    • September 23, 2016
    ...of covered items or services." 42 U.S.C. 1320a–7b(b)(3)(B). The bona fide employee safe harbor is discussed further in 42 C.F.R. § 1001.952(i), which provides that payments to employees "for employment in the furnishing of any item or service for which payment may be made in whole......
  • United States ex rel. Bartlett v. Ashcroft, Civil Action No. 3:04–57.
    • United States
    • United States District Courts. 3th Circuit. United States District Courts. 3th Circuit. Western District of Pennsylvania
    • August 21, 2014
    ...also known as the “safe harbors,” are provided by statute and in U.S. Department of Health and Human Services regulations found at 42 C.F.R. § 1001.952. The safe harbors encompass a number of payment practices—including contracts for office space, equipment, and personal services—and each e......
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153 cases
  • U.S. Ex Rel v. Ashcroft, Civil Action No. 3:04–57.
    • United States
    • United States District Courts. 3th Circuit. United States District Courts. 3th Circuit. Western District of Pennsylvania
    • August 21, 2014
    ...also known as the “safe harbors,” are provided by statute and in U.S. Department of Health and Human Services regulations found at 42 C.F.R. § 1001.952. The safe harbors encompass a number of payment practices—including contracts for office space, equipment, and personal services—and each e......
  • People v. Guiamelon, No. B232188.
    • United States
    • California Court of Appeals
    • July 25, 2012
    ...In response, the OIG received comments. (Department of Health and Human Services, Office of Inspector General, Rules and Regulations, 42 C.F.R. Part 1001, 56 Fed.Reg. 35957 (July 29, 1991).) The OIG noted that “[t]wo commenters requested that the OIG clarify the relationship between the [fe......
  • Sloan v. Sc Bd. of Physical Therapy ex'Mnrs, No. 26209.
    • United States
    • United States State Supreme Court of South Carolina
    • September 25, 2006
    ...and civil penalties for false claims and illegal kickbacks made under federal health care programs such as Medicare and Medicaid); 42 C.F.R. § 1001.952(i) (2005) (providing that prohibited "`remuneration' does not include any amount paid by an employer to an employee, who has a bona fide em......
  • U.S. Ex Rel v. Ashcroft, CIVIL ACTION NO. 3:04-57
    • United States
    • United States District Courts. 3th Circuit. United States District Courts. 3th Circuit. Western District of Pennsylvania
    • August 21, 2014
    ...also known as the "safe harbors," are provided by statute and in U.S. Department of Health and Human Services regulations found at 42 C.F.R. § 1001.952. The safe harbors encompass a number of payment practices—including contracts for office space, equipment, and personal services—and each e......
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258 firm's commentaries
  • CMS and the OIG Issue Final Rules Modernizing and Clarifying the Federal Stark and Anti-Kickback Laws
    • United States
    • JD Supra United States
    • December 22, 2020
    ...(42 CFR § 411.357(aa)(1))• Meaningful Downside Financial Risk Exception (42 CFR § 411.357(aa)(2))• Full Financial Risk Safe Harbor (42 CFR § 1001.952(gg))• Substantial Downside Risk Safe Harbor (42 CFR § 1001.952(ff))Other Value-Based Related Exceptions and Safe Harbors• Value-Based Arrange......
  • Patient Inducements: Gifts, Discounts, Waiving Co-Pays, Free Screening Exams, Etc.
    • United States
    • JD Supra United States
    • March 3, 2020
    ...of items or services to a beneficiary of a Medicare supplemental policy issued under the terms of section 1882(t)(1) of the Act. (42 C.F.R. § 1001.952(k)). Additional requirements apply to other types of providers. (Id.). Unless the provider can fit within the regulatory exception or otherw......
  • A Survey of Health Care Anti-Kickback Law at the State Level
    • United States
    • JD Supra United States
    • March 21, 2020
    ...1993) (finding that an agreement can be unlawful even if only one party has the improper intent). [8] 42 U.S.C. § 1320a-7b(b)(3)(A); 42 C.F.R. § 1001.952(h). [9] 42 U.S.C. § 1320a-7b(b)(3)(B); 42 C.F.R. § 1001.952(i). [10] 42 C.F.R. § 1001.952(d). [11] 42 C.F.R. § 1001.952(f). [12] Some of ......
  • Major Changes Finalized to Stark Rules, Anti-Kickback Statute Safe Harbors and the Beneficiary Inducements CMP
    • United States
    • JD Supra United States
    • December 1, 2020
    ...The Stark Law exceptions are codified at 42 C.F.R. § 411.351 and 42 C.F.R. § 411.357(aa); and the AKS safe harbors are codified at 42 C.F.R. §§ 1001.952(ee), (ff) and Key Definitions At the core of these Stark Law exceptions and AKS safe harbors is the protection of “value-based arrangement......
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5 books & journal articles
  • Health care fraud.
    • United States
    • American Criminal Law Review Vol. 47 Nbr. 2, March 2010
    • March 22, 2010
    ...(205.) Medicare and Medicaid Programs; Fraud and Abuse Anti-Kickback Provision, 54 Fed. Reg. 3088, 3092 (Jan. 23, 1989) (codified at 42 C.F.R. 1001.952). (206.) Id. (207.) Id. (208.) See 42 C.F.R. [section] 1001.952(g) (2009). (209.) Id. [section][section] 1001.952(g) (3), (4). The OIG atte......
  • Health care fraud.
    • United States
    • American Criminal Law Review Vol. 42 Nbr. 2, March 2005
    • March 22, 2005
    ...the invoice given to the buyer and must inform the buyer of its obligation to report discounts to HHS and State agencies upon request. 42 C.F.R. 1001.952 [section] (h)(2)(ii). If the amount of the discount is not known at the time of the sale the seller must provide the buyer documentation ......
  • Health care fraud.
    • United States
    • American Criminal Law Review Vol. 43 Nbr. 2, March 2006
    • March 22, 2006
    ...Medicare and Medicaid Programs; Fraud and Abuse Anti-Kickback Provision, 54 Fed. Reg. 3088, 3092 (Jan. 23, 1989) (to be codified at 42 C.F.R. 1001). (207.) Id. (208.) Id. (209.) 42 C.F.R. [section] 1001.952(g) (2005). (210.) Id. The OIG attempted to clarify the relationship between rules im......
  • Health care fraud.
    • United States
    • American Criminal Law Review Vol. 44 Nbr. 2, March 2007
    • March 22, 2007
    ...Medicare and Medicaid Programs; Fraud and Abuse Anti-Kickback Provision, 54 Fed. Reg. 3088, 3092 (Jan. 23, 1989) (to be codified at 42 C.F.R. 1001). (207.) Id. (208.) Id. (209.) 42 C.F.R. [section] 1001.952(g) (2005). (210.) Id. The OIG attempted to clarify the relationship between rules im......
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65 provisions
  • Securing Updated and Necessary Statutory Evaluations Timely
    • United States
    • Centers For Medicare And Medicaid Services,Public Health Service,The Inspector General Office
    • Invalid date
    ...(OIG), which is a component of HHS, although certain regulations for which OIG has enforcement responsibility are exempt, such as 42 CFR 1001.952. For regulations that were issued in coordination with another Agency, that function in concert with another Agency's regulations, or that have a......
  • Draft OIG Supplemental Compliance Program Guidance for Nursing Facilities
    • United States
    • Federal Register April 16, 2008
    • April 16, 2008
    ...liability under the statute. The following safe harbors are of most relevance to nursing facilities: Investment interests safe harbor (42 CFR 1001.952(a)); Space rental safe harbor (42 CFR Equipment rental safe harbor (42 CFR 1001.952(c)); Personal services and management contracts safe har......
  • OIG Supplemental Compliance Program Guidance for Nursing Facilities
    • United States
    • Federal Register September 30, 2008
    • September 30, 2008
    ...liability under the statute. The following safe harbors are of most relevance to nursing facilities: Investment interests safe harbor (42 CFR 1001.952(a)), Space rental safe harbor (42 CFR Equipment rental safe harbor (42 CFR 1001.952(c)), Personal services and management contracts safe har......
  • Medicare and State Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General's Civil Monetary Penalty Rules
    • United States
    • Federal Register May 12, 2014
    • May 12, 2014
    ...and safe harbors under the anti-kickback statute, a revised definition of remuneration in part 1003, and a codified gainsharing CMP (42 CFR 1001.952, 42 CFR part 1003). Each of the proposed rules is a stand-alone, independent rule, and the public need not wait for all of the proposed rules ......
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