(Already required in New York State)

It's time to dust off the old compliance manual. By March 23, 2013 skilled nursing facilities are required to have an operational compliance and ethics program.

In 2012, the U.S. Department of Health and Human Services, Office of the Inspector General will review Medicare -and Medicaid - certified nursing homes' implementation of compliance as part of their day-to-day operations. One of the things they will access is whether nursing homes' plans contain the elements identified in the Office of the Inspector General's (OIG) compliance program guidance.

The OIG has determined the following steps to be fundamental to an effective compliance program:

1. Implementing written policies, procedures and standards of conduct;

2. Designating a compliance officer and compliance committee;

3. Conducting effective training and education;

4. Developing effective lines of communication;

5. Enforcing standards through well publicized disciplinary guidelines;

6. Conducting internal monitoring and auditing; and

7. Responding promptly to detected offenses and developing corrective action.

If you or a colleague need more information regarding the substantive requirements of  a qualified compliance program contact Brandon Goldberg in our office at 609 454 5351.

Attorney Goldberg is a graduate of the Cornell University College of Arts and Sciences where he received his B.A. in Government and History.  He received his Juris Doctor from Emory University School of Law n Atlanta, GA. He is previously admitted to practice in New Jersey and Georgia.

In previous experience, Mr. Goldberg worked at the FAA;, the US Department of Housing and Urban Development, the State Court of Fulton County, Georgia and the Centers for Disease Control and Prevention in Atlanta , GA.

Jennifer Cohen Joins Law Firm and is Sworn in to the New York State Bar

Attorney Cohen is a graduate of Colgate University where she received a B.A. in International Relations and Peace & Conflict Studies in 2008.  She received her Juris Doctor and Health Law Certificate from the University of Maryland School of Law in May 2011.

In previous experience Ms. Cohen was an extern at the Medicaid Fraud Control Unit of the Maryland Attorney General's Office in Baltimore, MD, where she examined case files, identified Medicaid compliance and legal issues and worked with an interdisciplinary team of attorneys, investigators and auditors.

MACs have been sending out notices and will continue to do so until March 23, 2013. 

Once a provider receives notification from its MAC to revalidate, the most efficient way to do so is through the web-based Provider Enrollment, Chain and Ownership System (PECOS) at:https://pecos.cms.hhs.gov. PECOS allows you to review information currently on file, update and submit your revalidation via the internet. There is an application fee of $505 for each provider or supplier. Once submitted, the certification statement must be printed, signed, dated and mailed along with all required supporting documentation to the appropriate MAC immediately.

The enrollment fee can be paid via www.pay.gov using an electronic check, debit or credit card.  Type "CMS" in the search box under Find Public Forms and click the GO button. Click on the CMS Medicare Application Fee link.  Complete the form and submit payment as directed. A confirmation screen, which serves as a receipt, will display indicating that payment was made successfully.

In addition, CMS strongly recommends that this receipt be mailed to the Medicare contractor along with the Certification Statement for the enrollment application.

After many years of study by a task force that included representatives from the entire continuum of care New Jersey has adopted a universal transfer form that now must be used by all licensed health care providers when transferring a patient from one facility or agency licensed by the Department of Health and Human Services (DHSS)  to another.

Before the document was finalized it was pilot-tested in two phases.  Phase one was a nonscientific, real-world test involving 10 facilities to determine if the draft form had major faults. The results of the first phase offered minor suggestions to improve the form, which were adopted prior to the phase two trial.