Amended by section 10104 of the Manager’s Amendment. Requires Exchanges to account for activities, receipts and expenditures, with annual reporting to HHS, and provides for HHS investigations and audits of Exchanges.
Specifies protocol for rescissions of HHS payments for serious misconduct and allows HHS to implement approaches to reduce fraud and abuse. Includes provisions regarding the application of the False Claims Act (FCA) to payments made by, through or in connection with an Exchange if those payments include any Federal funds and makes changes to the application of the FCA public disclosure bar as specified.
Also requires, by January 1, 2019, a GAO report regarding Exchange activities and Qualified Health Plan enrollees addressing such issues as the operations and administration of Exchanges and how many physicians, by area and specialty, are not taking or accepting new patients enrolled in Federal healthcare programs; the report also must include a survey of the cost and affordability of healthcare insurance provided under the Exchanges for small business owners and employees.