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counterproductive state and local tax increases. Compliance Plan 1 - 8 Revised December 12, 2018 The American Recovery and Reinvestment Act of 2009 includes the Health Information Technology for Economic and Clinical Health Act, or the “HITECH Act,” which established programs under Medicare and Medicaid to provide incentive payments for the “meaningful use” of certified electronic health records (EHR) technology. H. The Patient Protection and Affordable Care Act (ACA) was signed by President Obama on March 23, 2010. The Affordable Care Act puts in place strong consumer protections, provides new coverage options and gives consumers the tools they need to make informed choices about their health. The Patient Protection and Affordable Care Act will ensure that all Americans have access to quality, affordable health care and will create the transformation within the health care system necessary to contain costs. The Congressional Budget Office (CBO) has determined that the Patient Protection and Affordable Care Act is fully paid for, will provide coverage to more than 94% of Americans while staying under the $900 billion limit that President Obama established, bending the health care cost curve, and reducing the deficit over the next ten years and beyond. The Patient Protection and Affordable Care Act contains nine titles, each addressing an essential component of reform: ·Quality, affordable health care for all Americans ·The role of public programs ·Improving the quality and efficiency of health care ·Prevention of chronic disease and improving public health ·Health care workforce ·Transparency and program integrity ·Improving access to innovative medical therapies ·Community living assistance services and supports ·Revenue provisions The Patient Protection and Affordable Care Act puts in place these comprehensive health insurance reforms that were rolled out beginning in 2010, over the next four years, and beyond. I. Other Laws and Regulations Affecting Health Care Providers and Payors Although government investigations have predominantly focused on the area of fraud and abuse, there are many other regulations that affect a health care plan’s operations. Although not the primary focus of recent government investigations, these other legal issues should be included in the corporate compliance program. Set forth below is a brief description of some of the other legal areas affecting health care organizations. Compliance Plan 1 - 9 Revised December 12, 2018 VIII. Discrimination FHCP will comply with all applicable Federal and State laws and regulations that prohibit improper discrimination. Such laws and regulations include, amongst others, Title VI of the Civil Rights Act, the Age Discrimination Act of 1975, Title II of the Americans With Disabilities Act (ADA) of 1990, Section 504 of the Rehabilitation Act of 1973, the Affordable Care Act (ACA), the Genetic Information Nondiscrimination Act of 2008 (GINA), and applicable non-discrimination regulations promulgated by the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services. FHCP will also comply with applicable Human Resource policies that prohibit unlawful discrimination. FHCP will not establish any policies, procedures, or processes that conflict with or prevent the application of regulations promulgated by HHS under Subtitle D of the ACA. FHCP will not unlawfully discriminate against any individual on the basis of an individual’s race, color, national origin, disability, age, sex, gender identity or sexual orientation in any aspect of our business. FHCP will also not unlawfully discriminate against individuals on the basis of an individual’s genetic information, health factor, expected length of life, present or predicted disability, degree of medical dependency, quality of life, other health conditions, religion, political beliefs, marital status, familial or parental status, or if all or part of an individual's income is derived from any public assistance program. FHCP has committed to upholding the language from Section 1557 of the Affordable Care Act which states that no person in the United States shall, on the ground of race, color, national origin, sex, age, or disability, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any health program or activity for which the Applicant receives Federal financial assistance from the Department. Examples of activities where FHCP will not discriminate include, but are not limited to: benefit/product design, rates, marketing, eligibility, sales, provider contracting/network design, delivery of health care services/supplies, and delivery of pharmaceuticals. FHCP will post its non-discrimination notice and tag lines in all clinical areas and pharmacies, and, include copies with all significant publications and/or communications such as applications, documents/correspondences related to rights, benefits or services, and correspondences requiring a response. FHPC’s notice of non-discrimination will include details about how to file a discrimination grievance. FHCP will also make free language services and aids available to ensure effective communication. Compliance Plan 1 - 10 Revised December 12, 2018 1. Regulations and Standards Healthcare entities operate in a highly regulated field and must comply with the regulatory provisions of numerous agencies. While many of these regulations do not carry criminal penalties, they do affect licensure and certification of healthcare delivery organizations. Examples of such regulatory authorities include: • Centers for Medicare and Medicaid Services (CMS) • Department of Health and Human Services (HHS) • Florida Agency for Health Care Administration (AHCA) licensure, Medicare certification and Certificate of Need for providers • Florida Department of Business and Professional Regulation (health professional licensure) • National Committee for Quality Assurance (NCQA Accreditation) • Food & Drug Administration (FDA) • Controlled Substance Registration • Pharmacy Licensure and Registration • Clinical Laboratory Licensure and Registration • Occupational Safety and Health Regulations (OSHA) • State of Florida Department of Financial Services/Office of Insurance Regulation (including oversight of health maintenance organizations) (DFS) XI. Enforcement Agencies The following agencies are actively involved in efforts to curb health care fraud and abuse: Agency Name Description Centers for Medicare & Medicaid Services (CMS) Federal agency overseeing administration of the Medicare, Medicaid, State Child Health Insurance Programs, and Federally Facilitated Marketplace . U.S. Department of Justice (DOJ) The chief law enforcement agency at the Federal level, which includes U.S. Attorneys Offices Federal Bureau of Investigation (FBI) Investigative arm of federal government (domestic) Medicaid Fraud Control Unit (MFCU): State Medicaid agency’s investigative arm Medicaid Plans State health insurance plans for the medically indigent. Compliance Plan 1 - 11 Revised December 12, 2018 Medicare Administrative Contractors (MACs) Claims processors of the Medicare Part A hospitals, skilled nursing facilities, and home health agencies. Claims processes for Medicare Part B (e.g. physicians, clinical, laboratories, durable medical equipment, and nursing home supplies) Medicare Drug Integrity Contractors (MEDICs) Assistance to CMS in audit, oversight, and anti-fraud and abuse efforts for