On August 10, 2012, HHSC-OIG posted proposed regulations that would expand the power and reach of the Office of Inspector General. These regulations broaden the net so that persons who are affiliated with a provider can be sanctioned along with a provider as a result of such affiliation, and “affiliate” is broadly defined. These regulations will allow the OIG to place a provider on payment hold upon a “credible allegation of fraud” (defined broadly) instead of the current “prima facie evidence” standard. Perhaps most consequential are the regulations on “self dealing.” The proposed regulations would basically adopt the federal anti-kickback prohibitions, but none of its safe harbors, which, if adopted, would wreak havoc in the market by affecting directorships, ownership of ASCs and hospitals, and consultation arrangements. The comment period for these proposed regulations is September 10, 2012.
