Not later than January 1, 1997, and not less than annually thereafter, the Secretary shall publish a notice in the Federal Register soliciting proposals, which will be accepted during a 60-day period, for-
After considering the proposals described in clauses (i) and (ii) of subparagraph (A), the Secretary, in consultation with the Attorney General, shall publish in the Federal Register proposed modifications to existing safe harbors and proposed additional safe harbors, if appropriate, with a 60-day comment period. After considering any public comments received during this period, the Secretary shall issue final rules modifying the existing safe harbors and establishing new safe harbors, as appropriate.
The Inspector General of the Department of Health and Human Services (in this section referred to as the "Inspector General") shall, in an annual report to Congress or as part of the year-end semiannual report required by section 405 of title 5, describe the proposals received under clauses (i) and (ii) of subparagraph (A) and explain which proposals were included in the publication described in subparagraph (B), which proposals were not included in that publication, and the reasons for the rejection of the proposals that were not included.
In modifying and establishing safe harbors under paragraph (1)(B), the Secretary may consider the extent to which providing a safe harbor for the specified payment practice may result in any of the following:
Not later than one year after December 29, 2022, the Inspector General shall conduct a review on whether to establish a safe harbor described in paragraph (1)(A)(ii) for evidence-based contingency management incentives and the parameters for such a safe harbor. In conducting the review under the previous sentence, the Inspector General shall consider the extent to which providing such a safe harbor for evidence-based contingency management incentives may result in any of the factors described in paragraph (2).
Not later than two years after December 29, 2022, the Secretary and the Inspector General shall submit to Congress recommendations, including based on the review conducted under subparagraph (A), for improving access to evidence-based contingency management interventions while ensuring quality of care, ensuring fidelity to evidence-based practices, and including strong program integrity safeguards that prevent increased waste, fraud, and abuse and prevent medically unnecessary or inappropriate items or services reimbursed in whole or in part by a Federal health care program.
The Secretary, in consultation with the Attorney General, shall issue written advisory opinions as provided in this subsection.
The Secretary shall issue advisory opinions as to the following matters:
Such advisory opinions shall not address the following matters:
Each advisory opinion issued by the Secretary shall be binding as to the Secretary and the party or parties requesting the opinion.
The failure of a party to seek an advisory opinion may not be introduced into evidence to prove that the party intended to violate the provisions of sections1 1320a-7, 1320a-7a, or 1320a-7b of this title.
Not later than 180 days after August 21, 1996, the Secretary shall issue regulations to carry out this section. Such regulations shall provide for-
Under the regulations promulgated pursuant to subparagraph (A)-
This subsection shall apply to requests for advisory opinions made on or after the date which is 6 months after August 21, 1996.
Any person may present, at any time, a request to the Inspector General for a notice which informs the public of practices which the Inspector General considers to be suspect or of particular concern under the Medicare program under subchapter XVIII or a State health care program, as defined in section 1320a-7(h) of this title (in this subsection referred to as a "special fraud alert").
Upon receipt of a request described in subparagraph (A), the Inspector General shall investigate the subject matter of the request to determine whether a special fraud alert should be issued. If appropriate, the Inspector General shall issue a special fraud alert in response to the request. All special fraud alerts issued pursuant to this subparagraph shall be published in the Federal Register.
In determining whether to issue a special fraud alert upon a request described in paragraph (1), the Inspector General may consider-
1So in original. Probably should be "section".
42 U.S.C. § 1320a-7d
EDITORIAL NOTES
REFERENCES IN TEXTSection 14(a) of the Medicare and Medicaid Patient and Program Protection Act of 1987, referred to in subsec. (a)(1)(A)(i), is section 14(a) of Pub. L. 100-93 which is set out as a note under section 1320a-7b of this title. The Internal Revenue Code of 1986, referred to in subsec. (b)(3)(B), is classified generally to Title 26, Internal Revenue Code.
AMENDMENTS2022-Subsec. (a)(1)(C). Pub. L. 117-286 substituted "section 405 of title 5," for "section 5 of the Inspector General Act of 1978 (5 U.S.C. App.),".Subsec. (a)(3). Pub. L. 117-328 added par. (3).2000-Subsec. (b)(6). Pub. L. 106-554 struck out ",and before the date which is 4 years after August 21, 1996" before period at end.1998-Subsec. (b)(2)(A). Pub. L. 105-277 inserted "or section 1320a-7a(i)(6) of this title" before period at end.1997-Subsec. (b)(2)(D). Pub. L. 105-33 substituted "section 1320a-7a(b)" for "section 1320a-7b(b)".
STATUTORY NOTES AND RELATED SUBSIDIARIES
EFFECTIVE DATE OF 1997 AMENDMENT Amendment by Pub. L. 105-33 effective as if included in the enactment of the Health Insurance Portability and Accountability Act of 1996, Pub. L. 104-191 see section 4331(f) of Pub. L. 105-33 set out as a note under section 1320a-7e of this title.
- Secretary
- The term "Secretary" means the Secretary of Housing and Urban Development.1See References in Text note below.
- person
- The term "person" means an individual, a trust or estate, a partnership, or a corporation.
- practices
- The term "practices" means design, financing, permitting, construction, commissioning, operation and maintenance, and other practices that contribute to achieving zero-net-energy buildings or facilities.