Transparency and Program Integrity
The Patient Protection and Affordable Care Act (PPACA)1 alone contains 59 separate sections of legislation dedicated to transparency and program integrity, 50 of which are found divided into the following subtitles in Title VI:
Title VI of PPACA enacts significant new transparency legislation and makes substantial modifications to existing administrative, civil, and criminal fraud and abuse statutes. As will be discussed further, PPACA amended the Stark Law2 to restrict physician ownership of hospitals to those grandfathered as of December 31, 2010, and to provide limits on physician-owned hospitals' abilities to expand. PPACA also enacts new laws to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, as well as protect and recognize elders' rights, including the right to be free of abuse, neglect, and exploitation.
The Affordable Care Act (ACA) provides for an infusion of $350 million in fraud and abuse enforcement funding, comprised of ...