Monday February 13, 2012
The Centers for Medicare and Medicaid Services (CMS) has
recently issued an updated S&C memo on reporting the reasonable
suspicion of a crime.
This memorandum informs SAs of the new section 1150B of the Act,
which was established by section 6703(b)(3) of the Affordable Care
Act and is entitled "Reporting to Law Enforcement
Occurring in Federally Funded Long-Term Care Facilities." In
order to promote timely application of the protections offered by
section 1150B of the Act for LTC facility residents, CMS is
explaining now the current obligations of LTC facilities to comply
with the law as it is plainly written, without any delay that might
be occasioned by waiting for any administrative rule-making process
that might further clarify application of the law.
The updates appear in the Definitions and Questions and Answers
In the definitions, the terms "agent" and "contractor" are
further defined in Appendix One. These definitions will assist
providers in determining who is included in "covered individuals."
In the Q&A section of the memo, additional clarity is
provided regarding the role of the facility in reporting the
suspicion of a crime. It should be noted that this memo
specifically states that a facility may report of a reasonable
suspicion of a crime directly to the state survey agency and law
enforcement on behalf of covered individuals. Additionally, the
Q&A section provides clarity about the impact of this
requirement on ICFs/MR.
Please see the attached S&C letter for more
Reporting Suspicion of Crime 20Jan2012 update