Health Care Matters

A Complimentary Newsletter From:

Law Offices Of David S. Barmak, LLC

Managing Risk for Long Term Care and Health Care Providers

Volume 13, Issue 2                             ADVERTISEMENT                                                  FEBRUARY 2012

In This Issue
Comprehensive Compliance Program Mandated by March 2013 for Skilled Nursing Facilities
Brandon Goldberg, Law Firm Associate is Admitted to District of Columbia Bar
Jennifer Cohen Joins Law Firm and is Sworn in to the New York State Bar
CMS Issues Revalidation Notices
New Jersey Makes Universal Transfer Form Mandatory

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David

David Barmak, Esq. 

Allison

Allison Whitehead, Esq. 

Brandon

Brandon Goldberg, Esq.

 
Jennifer Cohen

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Comprehensive Compliance Program Mandated by March 2013 for Skilled Nursing Facilities

(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.

 

 

 

 

Brandon Goldberg, Law Firm Associate is Admitted to District of Columbia Bar

Brandon C. Goldberg was recently sworn in to the Bar of the District of Columbia.  In his practice at the Law Offices Of David S. Barmak, LLC, Attorney Goldberg works with health care providers including skilled nursing facilities, practice groups and professionals on health care compliance issues and programs and general business counseling.

 

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

Jennifer B. Cohen; an associate at the Law Offices Of David S. Barmak, LLC was recently sworn in to the Bar of the State of New York, in Albany, NY.  In her practice at the Barmak law firm, Attorney Cohen works with health care providers, including skilled nursing facilities on compliance issues and programs.

 

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.

CMS Issues Revalidation Notices

The Centers for Medicare & Medicaid Services (CMS) reminded all providers and suppliers that enrolled with Medicare before March 25, 2011 that they must revalidate their enrollment information, but not until they receive notification from their Medicare Administrative Contractor (MAC).

 

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.

New Jersey Makes Universal Transfer

Form Mandatory

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. 

 

Five hospital systems and their referring and aftercare facilities participated in the phase two pilot.  Rutgers University was contracted to provide an objective, statewide phase two pilot of the Universal Transfer Form (UTF). The health care providers selected for this phase of the test were both in urban and suburban locales in all areas of the state, north, central and south.  Thirty five facilities from the five hospital systems participated in this phase of the pilot test.  Some of these facilities offered multiple levels of care and specialized units, including mental health. This 11 month field test produced four major criticisms: the form was too long, took too much time to fill out, staff members did not always have the information required and there were various suggestions to omit or reduce specific areas. Receivers were pleased to have accurate information on one form and offered ideas to reduce the length of the form. Most importantly, the overwhelming majority of senders and receivers in the field were quick to recognize the inherent advantages of a standardized transfer form. In parallel with phase two an electronic version of the UTF with one hospital and some of its post-acute partners was pilot-tested.  This was in anticipation of the expected development of and investment in more electronic health record applications in all health care settings.

 

Based on the evaluation of the pilot the task force made several changes and as a result the UTF was reduced to a one page document that captured the information needed at the time of transfer to ensure continuum of care.  In addition a comprehensive instruction sheet was developed to accompany the form.  The DHSS finalized the rules for all 1,900 licensed health care providers and made the form and instructions available late last year.

 

Electronic or paper completion of the UTF is permitted; considerable emphasis is being placed on electronic use of the form as a method to facilitate care transactions. Where possible it has been suggested that the UTF be integrated with the admission process as the patient's personal information covers the first third of the UTF and it may be possible to pre-populate this information from the admission form thus saving health care personnel time when completing the UTF.

Law Offices Of David S. Barmak, LLC
Our firm is dedicated to helping health care providers, in particular skilled nursing facilities, manage risk through a comprehensive compliance program that focuses on early intervention through on-site training, communication, policy & procedure review, monitoring and consultation. The program includes on site training in the areas of, but not limited to, fraud & abuse, HIPAA privacy and data security, employment, emergency preparedness, workplace violence, clinical documentation, sexual harassmentand social networking.

 

The firm's compliance team includes experienced compliance attorneys, clinical nurses, physical therapy and pharmacy consultants who are available to assist clients with pre and post Department of Health (DOH) survey procedures, respond to DOH questions, prepare for re-inspections, minimize risks for deficiencies, offer support to Directors of Nursing and correct care plans, incident reports and therapy notes, review Medicare billing, audit and review PPS/Medicare/Medicaid insurance documentation.

 

The recipient may, if the newsletter is inaccurate or misleading, report the same to the Committee on Attorney Advertising.

 

This newsletter has been prepared by the Law Offices Of David S. Barmak, LLC for informational purposes only and is not intended to provide legal advice. You should consult an attorney for advice regarding your individual situation. We invite you to contact us. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established.
 
For more information, please contact us:
Telephone (609) 454-5351
Fax (609) 454-5361
 
Copyright, 2012.  Law Offices Of David S. Barmak, LLC.  All rights reserved.
No portion of these materials may be reproduced by any means without the advance written permission of the author.