This week Health and Human Services Secretary Kathleen Sebelius testified in front of the Senate Finance Committee.  As a member of this committee I had many questions for her.  In particular, I questioned the consequences of whether health care plans participating in the Affordable Care Act are subject to key anti-fraud protections.

Secretary Sebelius stated in a letter to a House member that qualified health plans, programs related to the federally facilitated marketplace, and other programs under the Affordable Care Act are not considered federal health care programs.  I questioned whether this means Obamacare programs are not subject to federal anti-kickback statutes and the federal False Claims Act.

Secretary Sebelius argued that the federal exchanges offer plans from private insurers that should not be subject to anti-fraud protections.  This alarms me.  Billions of dollars in subsidies for individuals going to health insurers to join Obamacare are federal tax dollars.  Those dollars should be subject to anti-fraud laws.  Medicare Advantage also offers plans from private insurers and is subject to those same anti-fraud provisions.  I question why the two programs should be treated differently for federal anti-fraud protections.  Both involve direct payments from the government to private health care plans.

I intend to do everything I can to get to the bottom of whether the federal agency in charge of Obamacare will apply every available anti-fraud protection to this program.

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