(The Legal Intelligencer- second of two-part series on The Future of Long-Term Care Litigation)
While health care headlines focus on the implementation of Obamacare's individual mandate and establishment of insurance exchanges, the landmark legislation also is going to affect long-term care for older Americans.
Medicare- and Medicaid-certified nursing facilities must have had compliance and ethics programs in place by March, but regulations are still forthcoming.
Compliance programs for the health industry are not a new thing, said Susan V. Kayser, a partner with Duane Morris' New York office who chairs the long-term care and senior services subgroup of that firm's health law practice. The U.S. Department of Health and Human Services' Office of the Inspector General issued guidance in the 1990s for compliance programs on the basis of the federal sentencing guidelines, she said. New York is the first state to require Medicaid providers to have a compliance plan, she also added.
"I suspect that by and large, most nursing homes until earlier this year may not have had one," Kayser said. "And now they are required to have one."
Due to the fact the Centers for Medicare and Medicaid Services has not yet issued the regulations that would put the meat on the skeleton of the Affordable Care Act, "you have a legal requirement to have a compliance program with no real governing regulations," said consultant David Hoffman, whose firm works on compliance programs for nursing homes and is a former federal prosecutor who specialized in health care fraud and abuse.
To read the full report I wrote for The Legal Intelligencer: http://www.law.com/jsp/pa/PubArticlePA.jsp?id=1202618827884&Obamacare_to...
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