-
Friday May 17, 2013
The Centers for Medicare & Medicaid
Services (CMS) is publishing this article to provide clarification
of Federal guidance regarding Section 3108 of the Affordable Care
Act (ACA), related to physician delegation of certain tasks in SNFs
and NFs to NPPs (NPPs are formerly "physician extenders") such as
nurse practitioners (NPs), physician assistants (PAs), or clinical
nurse specialists (CNSs).
This article addresses the authority of NPs,
Pas, or CNSs to perform certain tasks such as conducting physician
visits and writing orders, and to sign certifications and
re-certifications.
-
Wednesday May 8, 2013
This updated Special Advisory Bulletin describes the scope and
effect of the legal prohibition on payment by Federal health care
programs for items or services furnished (1) by an excluded person
or (2) at the medical direction or on the prescription of an
excluded person. For purposes of Office of Inspector General (OIG)
exclusion, payment by a Federal health care program includes
amounts based on a cost report, fee schedule, prospective payment
system, capitated rate, or other payment methodology. It describes
how exclusions can be violated and the administrative sanctions OIG
can pursue against those who have violated an exclusion. The
updated Bulletin provides guidance to the health care industry on
the scope and frequency of screening employees and contractors to
determine whether they are excluded persons.
-
Friday May 17, 2013
In an arbitration ruling in December 2011 in case of The Estate
of Jane Doe versus ABC Health & Rehabilitation Center the terms
specified in the Medical Director Agreement played a significant
role in the Arbitration Panel ruling in favor of the defendant ABC
Health and Rehab. The Arbitration Panel members found there
had been no showing that any act or omission by the nurses at ABC
Health and Rehabilitation Center constituted a breach of the
applicable standard of care or caused the medical problems
culminating in the resident's death. A significant
factor in the favorable outcome of this case for the facility was
the terms of the Medical Director Agreement. The Medical
Director Agreement stated that the Medical Director was an
independent contractor; the roles of the medical director were
clearly stated and did not include a responsibility to diagnose or
treat patients. Rather, the agreement clearly stipulated that
any services the physician was to provide in that regard were to be
in his independent role as an attending physician and the facility
was not liable for the acts or omissions of the attending
physician.
Are the roles of your Medical Director in your Medical Director
Agreement clearly defined and separate from any acts he/she may
engage is as attending physician who has a responsibility to
diagnose and treat patients? If not you may wish to review
your contract with your corporate counsel and decide if
clarification is needed to this area or any other areas of the
agreement.
A sample Medical Director Agreement for your review is
available from the American Medical Director Association at the
link below. We do not recommend any changes to your agreement
without review and discussion with your corporate
counsel.
-
Thursday May 30, 2013
The Patient Protection and Affordable Care Act (PPACA)
required all Medicare/Medicaid Skilled Nursing Facilities to have
an effective Compliance and Ethics Program in place by March 23, 2013.
The primary purpose of the Compliance and Ethics Program is to
prevent, detect, and correct any fraud, abuse, or waste, to promote
quality of care, and to have an operational Compliance and Ethics
Program in place to meet applicable federal, state, and local laws
and regulations. In order to avoid potential exposure nursing
facility providers should take steps to implement the required
Compliance and Ethics Program.
Robinson Adams - Arthur J. Gallagher has partnered with
Associated Long Term Care Insurance Company, Johnston Barton
Proctor & Rose and Care2Learn to assist you with the
development of your Compliance and Ethics Program and training
along with answering any questions you may have concerning this
program.
Information from Johnston Barton Proctor & Rose on how they can
help you develop your Corporate Compliance Program:
Long
Term Care - Corporate Compliance Management
Johnston Barton
Proctor & Rose
Our law firm, in partnership with Robinson Adams - Arthur J.
Gallagher, has developed a Corporate Compliance Program Template
(the "Template") to assist long term care facilities in meeting
this requirement.
Our Template includes a corporate compliance program, employee
manual, copies of the applicable statutes and
regulations, in-service log and
instructions, corporate compliance hotline
information, and corporate compliance log and
instructions. The charge for the Template is $500.00.
Our law firm is also available to assist you with customizing and
implementing the Template for your facility at a discounted
rate.
If your facility is interested in purchasing the Template or if
our firm can provide your facility with any other assistance in
meeting the compliance program requirements of PPACA, please
call Angie Cameron at (205) 458-9489.
Care2Learn
You may also contact Stu DeVust at Care2Learn at 941-465-4578
to find out how you can enroll in the following Corporate
Compliance Online Courses:
-
Corporate Compliance - What You Need to Know
(USS-11600)
-
Corporate Compliance - What You Need to Know for Assisted
Living (USS-11600A)
-
Corporate Compliance and the Deficit Reduction Act for
Management (USS-11200)
Please contact Russ Crouch at 205-414-1390, or our vendor
partners, if you need additional information or assistance.