Modification of CMPs for skilled nursing facilities. A Proposed rule would modify the civil money penalties (CMPs) that are imposed on nursing homes for noncompliance with Medicare conditions of participation. The Patient Protection and Affordable Care Act (Pub. L. 111-148), Section 6111, amended Soc. Sec. Act §1819(h) and §1919(h) to address CMPs imposed by CMS. The key modifications created by the Proposed rule include: (1) an independent informal dispute resolution process (IDR) would be made available when a CMP is imposed; (2) payments made to satisfy a CMP imposed by an IDR would be placed in an escrow account pending completion of any formal appeal; and (3) a 50 percent reduction of a CMP would be made in certain cases for prompt correction of self-reported instances of noncompliance. The per day CMPs would be effective and continue to accrue but would not be collected while the CMP is subject to the independent IDR process, and collection of the CMP would occur either at the completion of an independent IDR or 90 days after notice has been given that a CMP would be imposed, whichever is earlier. When a facility’s formal appeal is successful, the CMP amount being held in escrow will be returned with interest. CMS would have new authority to reduce a CMP by 50 percent when CMS determines a facility has self-reported, promptly corrected its noncompliance, and waived its right to a hearing. However, noncompliance that constitutes immediate jeopardy, a pattern of harm, widespread harm, or results in a resident’s death would not be eligible for this reduction. Facilities that have repeated noncompliance for which a penalty reduction under this provision was received during the previous year would not be eligible for another reduction. A facility’s request for an independent IDR must be made within 30 days of notice of the imposition of the CMP and the independent IDR must be completed within 60 days of the imposition of the CMP. A portion of the CMPs attributable to Medicare may be used for the protection or benefit of nursing home residents. All comments regarding the Proposed rule must be received by 5 p.m. eastern standard time on August 11, 2010.
Proposed rule, 75 FR 39641, July 12, 2010.
CMS Letter to State Survey and Certification Agencies, No. S&C-10-23-NH, July 12, 2010.For more information on this and related topics, consult the CCH® Medicare and Medicaid Guide.
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