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Covered Recipient: Key Insights into Legal Definitions and Implications
Definition & Meaning
A covered recipient is defined as a physician or a teaching hospital that receives certain payments or transfers of value from applicable manufacturers. However, it does not include physicians who are employees of the applicable manufacturer. This term is significant in the context of transparency in healthcare, particularly regarding financial relationships between healthcare providers and pharmaceutical or medical device companies.
Table of content
Legal Use & context
The term "covered recipient" is primarily used in healthcare law and regulations, particularly in relation to the transparency requirements set forth by the Physician Payments Sunshine Act. This law mandates that applicable manufacturers report payments or other transfers of value to covered recipients. Understanding this term is essential for compliance with federal regulations, and it may involve the use of specific legal forms to ensure proper reporting and disclosure.
Key legal elements
Real-world examples
Here are a couple of examples of abatement:
Example 1: A pharmaceutical company provides a grant to a teaching hospital for research purposes. The hospital is considered a covered recipient under the Sunshine Act.
Example 2: A physician who works as a consultant for a medical device company is a covered recipient if they receive payments for their services, but if they are an employee of that company, they do not qualify as a covered recipient. (hypothetical example)
Relevant laws & statutes
The term "covered recipient" is defined under the Physician Payments Sunshine Act, specifically referenced in 42 USCS § 1320a-7h (e) (6) (A). This law aims to promote transparency in the financial relationships between healthcare providers and manufacturers.
Comparison with related terms
Term
Definition
Key Differences
Covered Recipient
A physician or teaching hospital receiving payments or value from manufacturers.
Excludes employees of applicable manufacturers.
Applicable Manufacturer
A company that produces or markets drugs, devices, or biological products.
Refers to the entity providing payments, not the recipient.
Teaching Hospital
An institution that provides clinical education and training to future and current health professionals.
Specific type of covered recipient under the Sunshine Act.
Common misunderstandings
What to do if this term applies to you
If you are a physician or part of a teaching hospital receiving payments from manufacturers, ensure you understand your obligations under the Sunshine Act. You may want to review your reporting requirements and consider using legal form templates from US Legal Forms to assist with compliance. If your situation is complex, consulting a legal professional may be necessary.
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