• CMS Updates Information Related To Reporting Reasonable Suspicion of a Crime

    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 of Crimes 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 sections.

    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 detailed information.

    Reporting Suspicion of Crime 20Jan2012 update

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