As state and federal agencies work to create operational health exchanges, one critical question remains unanswered: How will the key stakeholders participate in the new health exchanges? Read More
Archive for the ‘In the News’:
March 21st, 2013
March 21st, 2013
Through the passage of the Patient Protection and Affordable Care Act (“Act”), the Patient-Centered Outcomes Research Institute (“Institute”) was created to promote research to advance the quality of evidence-based medicine. The Institute is funded through the Patient-Centered Outcomes Research Trust Fund, which is financed, in part, by fees paid by plan sponsors of applicable self-insured health plans and issuers of specified health insurance policies. For the first year of applicability, the fee is $1 per covered life and increases for later years.
The first deadline for payment of the Patient-Centered Outcomes Research Institute (PCORI) fee is this July 31, 2013.
November 30th, 2012
For the last several months, Michigan has been preparing to partner with the federal government to create a health exchange. This month, Governor Snyder filed materials with the United States Department of Health and Human Services (“HHS”) to move forward with the partnership. As part of this process, Michigan reserved its option to create a state-based health exchange. However, it now appears that Michigan will not exercise this option and will continue to move forward with its partnership with HHS under the framework of a federally-facilitated exchange.
Yesterday, pending legislation to create a state-based health exchange failed to gain necessary support from the state House Health Policy Committee. Senate Bill 693, which was designed to create Michigan’s state-based health exchange called MI Health Marketplace, was defeated in committee on a 9-5 vote, with two abstentions. Resistance to SB 693 was fueled by lingering, unanswered questions related to a health-based system, especially with respect to the future costs to Michigan taxpayers.
Despite Michigan’s election to form a partnership exchange with HHS, Michigan can still establish a state-based exchange to take over operations in 2015.
To find out more about the Michigan health exchange and the impact the Affordable Care Act has on health care, contact attorney Michael James at email@example.com, 517-377-0823 or www.fraserlawfirm.com. Michael James, a senior attorney at Fraser Trebilcock, provides representation and counseling related to all facets of business enterprise and healthcare matters.
October 11th, 2012
The deadline to seek an Independent Foreclosure Review has been extended. You now have until December 31, 2012 to file a claim to determine if you are eligible to receive up to $125,000.
Borrowers should keep in mind that the Independent Foreclosure Review is just one of many federal, state and bank sponsored processes created to assist borrowers who were harmed by foreclosure abuses and/or struggling through the current housing crisis. While some of these programs are aimed at compensating borrowers for past, improper conduct, others are designed to help borrowers remain in their homes by creating more manageable mortgage payments. You should contact an attorney to discuss your eligibility and the requirements for recovery under the various programs. For more information, please contact an attorney in Fraser Trebilcock’s Real Estate Practice Group.
October 10th, 2012
By: Daniel Cherrin, Esq.
[As Article first appeared in the October 8, 2012 issue of Michigan Lawyers Weekly]
“Politics and issues come and go, but in the end, we’ll all be remembered for the way we treat other people.”
Morris K. Udall
The National Policy Consensus Center has found that legislators are becoming problem solvers, facilitators and conveners of issues vital to their state. Yet in Michigan, legislators and other elected officials fail each year to come to a consensus on regional transportation, border policy, health care and other issues.
In fact, today, public policy disputes have the potential of polarizing communities with the affect of delaying important decisions on vital issues of public policy, often resulting in diluted policies or no action at all. For example, as we enter the prime of the election season, Congress has yet to reauthorize: A Farm Bill that was last reauthorized in 2008 and an Education Bill that expired in 2007.
In addition, strains on government budgets and demands for more efficiency are stirring new interest in merging cities with counties or blending regional services such as water, public safety and more. For example Davison and Davison Township created a taskforce to explore opportunities for collaboration and consolidation and the City of Adrian has developed a plan to consolidate library services with Lenawee County. And earlier this year, the State Bar Judicial Crossroads Task Force issued its report recommending court consolidations. In fact, a recent survey by Business Leaders for Michigan found that Michigan voters support the idea of consolidating government services, such as transportation, public safety and other administrative function, although the same voters oppose consolidating township or village governments entirely and increasing the role played by counties.
Mediation is a process in which an impartial third party – a mediator – facilitates the resolution of a dispute by promoting a voluntary agreement between the parties involved in the dispute. Mediation facilitates communication, promotes understanding, focuses the parties on their interests, and employs creative problem solving to help the parties reach their own agreement. Settlement discussions go beyond simple legal rights and obligations, and analyze the underlying issues and risks involved in a potential trial.
For example, in Hamilton County, Ohio, successful mediation led to an agreement on a comprehensive revision of the Hamilton County, Ohio Zoning Code. The Hamilton County Commissioners convened this group, that included organizing over 100 participants into 7 working groups.
Collaborative Policy Making (or Public Policy Dispute Resolution), can help resolve some of the high-profile policy disputes that remain in Congress, the legislature and in local governments, and find resolution through controversy and clarity amidst chaos. To assist governments in resolving disputes by and between each other, the disputants need a trusted third party neutral that is knowledgeable about the issues, while being sensitive to the politics of the people involved. A university provides elected leaders with an unbiased academic approach to public policy dispute resolution. Yet, unlike other states with centers for public policy dispute resolution, no university in the State of Michigan has such a center.
ADR and the public sector
From cities facing a financial crises and potential emergency manager, to the multiple issues affecting a new border crossing, to budget battles and fights over pension reform and school closures and consolidation of city services, the various government leaders need the support and guidance of a neutral third party to resolve these disputes and bring some closure to a number of long standing issues.
Public policy dispute resolution is a process whereby one or more public agencies craft a solution to a policy issue using consensus-driven dialogue with diverse parties who will be affected by the solution or who can help to implement it. It leads to innovation, creative solutions and relationship enhancement.
In public policy dispute resolution, for example, all the interested stakeholders come together with the help of a third party neutral who will assist the stakeholders in reaching consensus. Public policy dispute resolution provides for a nonpartisan process for resolving public policy disputes, and has proven successful at all levels of government. In fact, it is emerging as a more effective way of dealing with some of the most polarizing issues, such as: Community development; Energy and the environment; Health care; Land use; Transportation & Intergovernmental disputes among others.
Consensus building is a process by which the parties seek unanimous agreement. It involves a good-faith effort by each stakeholder to meet the interests of each other. In today’s legislative environment, politics often trumps policy and public policy dispute resolution can assist lawmakers and regulators in reaching consensus and bring closure to a number of issues that have long been unresolved, while overcoming outside political pressure.
For example, in 1996, the State of Michigan, along with the other Great Lakes states participated in mediation in order to resolve the conflict over Chicago’s diversion of Lake Michigan water. The United States Justice Department and Solicitor General’s Office convened a mediation process ending years of conflict, producing a Memorandum of Agreement between all eight states on how to manage the world’s largest source of fresh water.
As alternative dispute resolution becomes a more accepted practice to resolving disputes, various governments are giving serious thought to integrating ADR in resolving issues in various levels of governments. Public policy dispute resolution has worked in states such as Texas, New Mexico, Utah and Virginia, where each state has passed legislation creating a policy dispute resolution process. The most successful states in dispute resolution are those that have specific legislation or rules, directing disputing parties to resolve their issues through mediation.
To make public policy dispute resolution a reality in Michigan, lawmakers should be encouraged to review current law and regulations and determine where mediation may make sense. In addition, current House and Senate Rules should be revised to trigger mediation in the legislative process.
In addition, universities here in Michigan should be encouraged to create an Institute of Public Policy Dispute Resolution, similar to ones other states, to assist the State in this process and work with government officials to resolve policy disputes, while serving as a facilitator of other issues by and between governments in the state of Michigan.
Policymakers can avoid making difficult decisions on controversial issues by creating a process by which public policy disputes can be resolved. Through a facilitated consensual process, issues such as government shutdowns, delayed projects and other missed opportunities can be avoided and we can all move on to other issues to help Michigan move forward.
Decisions that are reached collaboratively can result in high-quality outcomes that are easier to implement, receive fewer legal challenges, make better use of available resources, and better serve the public. Simply, better policy can be made when decision-makers have more data and a deeper understanding of the interests of all those involved.
Collaboration is not appropriate for all decisions. It is not necessary or recommended to use a formal collaborative process for routine, simple, or urgent decisions. Collaborative processes are often effective when applied to complex policy questions that affect multiple, interdependent interests, where all the diverse parties affected have compelling reasons to engage with one another in a search for a joint policy or program outcome, and where sufficient time and resources are available to support the process. However, research has shown that collaborative processes often create a long term “network dynamic” of shared learning, improved working relationships, and better joint problem solving ability in the future.
# # # # #
September 17th, 2012
College is about investing in your future. For most students, the investment is rooted in obtaining an education to help achieve career goals. However, some students have a different investment strategy. These students often forego extracurricular activities and endure countless sleepless nights in an effort to launch their careers while still in college. For some collegiate entrepreneurs, the investment has paid off exponentially. But how were collegiate entrepreneurs like Gates, Dell and Zuckerberg able to achieve such great success?
Regardless of whether you are trying to create the next social media revolution from your dorm room or start a property management company in your college town, there are a number of key principles that every aspiring collegiate entrepreneur should adhere to. While these principles will not guarantee success, they will help you overcome some of the most common obstacles that hinder entrepreneurial ventures.
First, you must have clarity. Before you start a venture, you need to have a goal for what you would like to accomplish and a plan for how you are going to achieve it. Sound simple? In practice, clarity takes time. Clarity involves identifying existing products/services, evaluating the market, sizing up potential competition and focusing on specific customers/consumers. These steps will not only help you gauge the feasibility of your idea, but they will also bring your idea into focus. Once you take these initial steps, you need to develop a strategy to bring your idea to life. This strategy should be memorialized in a comprehensive business plan. A business plan will guide you through the startup process and will serve as an important tool to gain support from investors and strategic partners. Ultimately, if you are unable to clearly articulate your idea and plan, your venture will not succeed.
Second, you must stay focused. One of the biggest mistakes made by entrepreneurs is that they get involved in too many projects at the same time. Once you have your idea and plan in place, stick with it. You must stay focused on your plan in order to achieve success. Don’t start the next venture until you have stabilized the first one or seen it through. Dividing your time and resources between too many projects is a surefire way to guarantee failure. In addition, stay focused on what you are good at. If you have never written a line of computer code, it is probably not a good idea to start a smartphone app company on your own. You will have a higher likelihood for success if your venture is centered around your strengths. Finally, you need to set intervals to honestly evaluate the development of your venture. These benchmarks or milestones will help you stay focused on achieving your goals and help you assess your progress. Initially, make sure to give yourself extra time and start small with your benchmarking.
Third, you have to be patient. Patience is by far the most important principle to achieve success. You are going to spend an immeasurable amount of time refining your idea, developing a viable business plan and starting up your venture. You have to give your plan time to work! Don’t waste time and energy constantly evaluating your venture. Instead, focus on value-added activities and wait for your planned benchmarks to size up your progress. Don’t let impatience be the downfall of your venture.
Finally, you have to be ready to adapt your idea and business plan. Unexpected change is almost the only certainty in today’s business environment. If your venture is going to succeed, you need to embrace the change that surrounds you instead of fighting against it. In addition, you need to surround yourself with the right people. For entrepreneurs, the “right people” are going to be those individuals who are good at the things that you are not good at. Your human capital should complement your skill sets and fill any voids identified in your business planning process. Ultimately, your venture needs to achieve a healthy balance between staying focused on its goals and being ready to adapt to sudden and progressive change in the market.
If your investment strategy for college involves building the foundation for your own business, you need to make sure you have the right investment tools. Although every business is unique, the principles discussed above are proven cornerstones for successful entrepreneurial ventures. Collegiate entrepreneurs who want to transform an idea into a successful career should integrate these principles into their existing or future undertakings.
To find out more about starting your own business or to gain guidance related to your venture, contact attorney Michael James at firstname.lastname@example.org, 517-377-0823 or www.fraserlawfirm.com. Michael James, a senior attorney at Fraser Trebilcock provides representation and counseling related to all facets of business enterprise and healthcare matters.
August 28th, 2012
As a reminder, your college-bound children should have a durable power of attorney and designation of patient advocate in place before they head off to school this fall. In general, anyone over the age of 18 should have these documents prepared. These documents allow your child to authorize another individual to act on his or her behalf in certain situations. Contrary to what most believe, parents do not have any authority to act on behalf of their adult children (age 18 and older) simply because they are “parents” without such documents in place.
A durable power of attorney deals with business and financial matters. This document allows the agent named to act on behalf of the college student when necessary, and without the college student needing to be present to act on his or her own behalf. For example,
• It allows an agent, such as one’s parents, to handle banking matters for the student while they are away from home.
• It allows an agent, such as one’s parents, to handle tuition payments and rental agreements, etc. for the student.
• It allows an agent to sign legal documents on behalf of the student while they are away from home.
• In the unfortunate event of an unexpected disability, it allows an agent to handle all of the student’s business and financial affairs, including school affairs, while they are unable to do so.
A designation of patient advocate deals with health care matters. This document permits an individual to name one or more individuals (called patient advocates) to make care, custody, and medical and/or mental health decisions for the individual, but only when he or she can no longer make those decisions on his or her own (as certified by two physicians), and also permits an individual to authorize the withholding or withdrawal of life support systems, and authorize or refuse organ donation in the event of death. The main reason why a college student should have a designation of patient advocate is because:
• Accidents happen. If for any reason, the student is unable to make medical or mental health care treatment decisions for him or herself, the student’s designated patient advocate can do so according to the student’s predetermined wishes.
If you have a child heading off to college this fall, please educate them on the importance of having a durable power of attorney and designation of patient advocate in place. If you have questions or would like to speak to someone about preparing these documents, please contact Melisa M. W. Mysliwiec. Melisa can be reached at 616-301-0800 or 800-748-0436, or by e-mail at email@example.com.
August 21st, 2012
The government has revised the CHIP Notice as of July 31, 2012. As you are likely preparing and updating your open enrollment materials, if you are required to send the CHIP notice, please be sure to use the revised notice:Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
The Children’s Health Insurance Program Reauthorization Act of 2009 (“CHIPRA” or the “Act”), signed into law in 2009, extends the State Children’s Health Insurance Program established under the Social Security Act (“CHIP”).
CHIPRA allows states to subsidize premiums for employer-provided group health coverage for eligible children and families. Under the Act, states may elect to provide a premium assistance subsidy (the “Subsidy”) to low-income employees who want to change their single coverage to family coverage in order to cover a CHIP or Medicaid eligible dependent. Pursuant to the Act, a state may elect to offer the Subsidy for “qualified employer-sponsored coverage”.
Michigan currently does not offer such subsidy, but if you have any employees living in another State which does, you must provide the attached CHIPRA notice to those employees. [The notice in this link sets forth those States which do offer the subsidies].
Under the Act, group health plans will have to notify each employee of potential Subsidy opportunities currently available in the state in which the employee resides. Where there is a state Subsidy in place, each employer that maintains a group health plan will be required to give notice to participants about the Subsidy. Under the Act, group health plans may distribute notices concurrently with the group health plan enrollment materials, open enrollment materials, or the SPD.
This is an ANNUAL notice which must be provided free of charge to employees living in affected States before the start of each plan year (i.e., for calendar year plans, prior to each January 1st).
If you would like further information regarding the above matters, health care reform, or employee benefits in general, please feel free to contact our office. You can reach attorney Elizabeth Latchana at firstname.lastname@example.org or 517-377-0826.
August 20th, 2012
Gifting opportunity expires at end of 2012.
Current law allows individuals an equivalent tax exemption of up to $5,120,000 to apply to estates, gifts and generation-skipping transfers. Unless Congress acts prior to December 31, 2012, that amount will revert to $1,000,000 on January 1, 2013. Further, while this year’s top tax rate is 35%, that rate will rise to 55% on January 1st. Given these facts, there may never be a better time for you to consider gifting (including gifts of cash, real property, interests in closely held business entities, forgiveness of debt and gifts in trust). Taking advantage of this historically large gift tax exemption may save you and your family significant tax dollars. We are ready to work with you and your other trusted advisors to consider these issues and to make recommendations. Since some gifts require appraisals, you will need to allow adequate time for obtaining valuations and completing asset transfers. Now is the time to plan! Please give an attorney in our Trusts and Estates Department a call if we may be of help.
August 13th, 2012
New Requirements for Nursing Facilities Under the Affordable Care Act
Compliance, Quality Assurance & Performance Improvement Programs for Skilled Nursing Facilities and Nursing Facilities
Does your Skilled Nursing Facility (SNF) or Nursing Facility (NF) have a compliance program in place? Has your organization developed quality assurance practices? Are performance improvement metrics integrated throughout your operations? If your SNF or NF does not have or is not utilizing these programs, you may find yourself in violation of the Affordable Care Act (ACA) in the very near future. Under Section 6102 of the ACA, each SNF and NF is required to develop a compliance and ethics program and participate in a quality assurance and performance improvement program. These programs are consistent with the goals of the ACA to promote accountability for patient care and to redesign care processes to ensure high quality and efficient service delivery. Each of these programs are discussed in more detail below.
Compliance and Ethics Programs
Compliance and ethics programs are important part of the ACA. Under the ACA, each Medicare and/or Medicaid certified nursing facility must have in operation a compliance and ethics program three years after the effective date of the act. As such, the deadline to implement a compliance and ethics program is March 23, 2013.
According to the ACA, the programs must be effective in preventing and detecting criminal, civil, and administrative violations and in promoting quality of care. To accomplish these goals, the ACA outlines eight components required for a compliance and ethics program:
- The organization must have established compliance standards and procedures to be followed by its employees and other agents that are reasonably capable of reducing the prospect of criminal, civil, and administrative violations.
- Specific individuals within high-level personnel of the organization must have been assigned overall responsibility to oversee compliance with such standards and procedures and have sufficient resources and authority to assure such compliance.
- The organization must have used due care not to delegate substantial discretionary authority to individuals whom the organization knew, or should have known through the exercise of due diligence, had a propensity to engage in criminal, civil, and administrative violations under the law.
- The organization must have taken steps to communicate effectively its standards and procedures to all employees and other agents, such as by requiring participation in training programs or by disseminating publications that explain in a practical manner what is required.
- The organization must have taken reasonable steps to achieve compliance with its standards, such as by utilizing monitoring and auditing systems reasonably designed to detect criminal, civil, and administrative violations under this Act by its employees and other agents and by having in place and publicizing a reporting system whereby employees and other agents could report violations by others within the organization without fear of retribution.
- The standards must have been consistently enforced through appropriate disciplinary mechanisms, including, as appropriate, discipline of individuals responsible for the failure to detect an offense.
- After an offense has been detected, the organization must have taken all reasonable steps to respond appropriately to the offense and to prevent further similar offenses, including repayment of any funds to which it was not entitled and any necessary modification to its program to prevent and detect criminal, civil, and administrative violations.
- The organization must periodically undertake reassessment of its compliance program to identify changes necessary to reflect changes within the organization and its facilities.
Three years after the compliance programs are put into place, the United States Department of Health and Human Services (HHS) is required to evaluate the programs to determine the extent to which the programs have led to changes in deficiency citations and quality performance, and make a report to Congress.
The ACA required the Centers for Medicare and Medicaid Services (CMS) to issue regulations by March 23, 2012 related to nursing facility compliance plans. CMS did not meet this deadline. However, one should expect the regulations to be forthcoming given the Supreme Court’s recent decision upholding the constitutionality of the ACA. In the interim, the eight areas outlined above should be used by SNFs and NFs to structure compliance plans or modify existing compliance plans.
The requirements that will be imposed by the new regulations will likely vary with the size of the organization that operates the facility. The ACA states that:
Larger organizations should have a more formal program and include established written policies defining the standards and procedures to be followed by its employees. Such requirements may specifically apply to the corporate level management of multi-unit nursing home chains.
It should be noted that the Office of the Inspector General (OIG) has listed nursing facility compliance plans in its 2012 Work Plan. The 2012 Work Plan states:
We will review Medicare- and Medicaid-certified nursing homes’ implementation of compliance plans as part of their day-to-day operations and whether the plans contain elements identified in OIG’s compliance program guidance. We will assess whether CMS has incorporated compliance requirements into Requirements of Participation and oversees provider implementation of plans. Section 6102 of the Affordable Care Act requires nursing homes to operate a compliance and ethics program, containing at least 8 components, to prevent and detect criminal, civil, and administrative violations and promote quality of care. The Affordable Care Act requires CMS to issue regulations by 2012 and SNFs to have plans that meet such requirements on or after 2013.
The OIG has previously released compliance program guidance for nursing facilities. In the past, facilities may have viewed these OIG releases as optional. This is no longer the case. By putting nursing facility compliance plans in its 2012 Work Plan, the OIG appears to be prepared to enforce these guidance provisions. At a minimum a nursing facility’s compliance plan should meet the standards outlined in the OIG’s guidance releases.
Quality Assurance & Performance Improvement Programs
Section 6102 of the Affordable Care Act also requires HHS to establish and implement a quality assurance and performance improvement program (“QAPI program”) for facilities, including multi-unit chains of facilities. The ACA required that the regulations for the QAPI program be completed by December 31, 2011. Here too, it does not appear that CMS met this deadline. However, CMS’s webpage indicates that a national rollout of the QAPI program is set for summer 2012. Here, CMS will post early prototypes of some of the tools and resources it has been developing for the QAPI program. CMS states that this will be an opportunity for nursing facilities to try out these tools and provide feedback. The tools can be downloaded off of CMS’s website. Ultimately, it does not appear that the QAPI program will be fully operational this summer, as CMS is still in the testing and evaluation stage of the program. However, nursing facilities must be prepared to implement a QAPI program in the very near future. The five key elements discussed below should serve as a starting point to creating a QAPI program that will be compliant with the forthcoming federal regulations.
Under the ACA, the Secretary shall establish standards relating to quality assurance and performance improvement with respect to facilities and provide technical assistance to facilities on the development of best practices in order to meet such standards. As noted above, these regulations have not been completed. However, CMS has released guidance as to the five key elements of a QAPI. They are as follows:
- Element 1: Design and Scope – A QAPI program must be ongoing and comprehensive, dealing with the full range of services offered by the facility, including the full range of departments. When fully implemented, the program should address clinical care, quality of life, resident choice, and care transitions. It aims for safety and high quality with all clinical interventions while emphasizing autonomy and choice in daily life for residents (or resident’s agents). It utilizes the best available evidence to define and measure goals. Nursing facilities will have in place a written QAPI plan adhering to these principles.
- Element 2: Governance and Leadership – The governing body and/or administration of the nursing home develops and leads a QAPI program that involves leadership working with input from facility staff, as well as from residents and their families and/or representatives. The governing body assures the QAPI program is adequately resourced to conduct its work. This includes designating one or more persons to be accountable for QAPI; developing leadership and facility-wide training on QAPI; and ensuring staff time, equipment, and technical training as needed for QAPI. They are responsible for establishing policies to sustain the QAPI program despite changes in personnel and turnover. The governing body and executive leadership are also responsible for setting priorities for the QAPI program and building on the principles identified in the design and scope. The governing body and executive leadership are also responsible for setting expectations around safety, quality, rights, choice, and respect by balancing both a culture of safety and a culture of resident-centered rights and choice. The governing body ensures that while staff are held accountable, there exists an atmosphere in which staff are not punished for errors and do not fear retaliation for reporting quality concerns.
- Element 3: Feedback, Data Systems and Monitoring – The facility puts in place systems to monitor care and services, drawing data from multiple sources. Feedback systems actively incorporate input from staff, residents, families, and others as appropriate. This element includes using Performance Indicators to monitor a wide range of care processes and outcomes, and reviewing findings against benchmarks and/or targets the facility has established for performance. It also includes tracking, investigating, and monitoring Adverse Events that must be investigated every time they occur, and action plans implemented to prevent recurrences.
- Element 4: Performance Improvement Projects (PIPs) – The facility conducts Performance Improvement Projects (PIPs) to examine and improve care or services in areas that are identified as needing attention. A PIP project typically is a concentrated effort on a particular problem in one area of the facility or facility wide; it involves gathering information systematically to clarify issues or problems, and intervening for improvements. PIPs are selected in areas important and meaningful for the specific type and scope of services unique to each facility.
- Element 5: Systematic Analysis and Systemic Action – The facility uses a systematic approach to determine when in-depth analysis is needed to fully understand the problem, its causes, and implications of a change. The facility uses a thorough and highly organized/ structured approach to determine whether and how identified problems may be caused or exacerbated by the way care and services are organized or delivered. Additionally, facilities will be expected to develop policies and procedures and demonstrate proficiency in the use of Root Cause Analysis. Systemic Actions look comprehensively across all involved systems to prevent future events and promote sustained improvement. This element includes a focus on continual learning and continuous improvement.
Not later than 1 year after the date on which the regulations are promulgated, a facility must submit to the Secretary a plan for the facility to meet such standards and implement such best practices, including how to coordinate the implementation of such plan with quality assessment and assurance activities conducted under sections 1819(b)(1)(B) and 1919(b)(1)(B), as applicable.
Ultimately, facilities should begin to create QAPI programs that are consistent with the elements released by CMS in advance of the federal regulations. Facilities should also consider downloading the prototype programs released by CMS this summer so that they are familiar with the direction CMS is taking and can prepare to be ahead of the curve.
Under the ACA, the regulatory environment for Skilled Nursing Facilities and Nursing Facilities has drastically changed. These changes will likely impact facilities’ policies, operations and management practices. Therefore, it is important that facilities take the appropriate steps to be ready for upcoming changes in the law under the ACA. In addition, facilities should currently have procedures in place consistent with the OIG’s guidance on compliance programs. Facilities should consult with experienced health care and business counsel in order to develop compliance, ethics, quality assurance and performance improvement programs.
To find out more about the changing regulatory environment for nursing facilities, contact attorney Michael James at email@example.com, 517-377-0823 or www.fraserlawfirm.com. Michael James, a senior attorney at Fraser Trebilcock provides representation and counseling related to all facets of business enterprise and healthcare matters.