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Posts tagged "Ethics"

Compliance and Ethics Program Implementation

Effective November 28, 2019, the Phase III requirements of the Long Term Care Requirements of Participation require all nursing facilities to implement a Compliance and Ethics program consistent with the dictates of 42 CFR § 483.85 (F895). The Rule obligates facilities to have a written compliance and ethics program in place that is likely to be effective in preventing and detecting criminal, civil, and administrative violations under the Social Security Act and in promoting quality of care. The Regulation lists multiple requirements for the program, which relate to historical compliance guidance issued by other federal agencies, including the Office of the Inspector General.

CMS Proposes Compliance and Ethics Program Requirements for Long Term Care Providers

The Affordable Care Act required long term care provider to implement a corporate compliance plan by March 23, 2013. Despite the Act's requirements, neither CMS nor the OIG have promulgated regulations to carry out this statutory mandate. However, in the July 16, 2015 Federal Register.pdf, containing the proposed changes to the Requirements of Participation for long term care facilities, CMS proposes to add a new regulation, 42 CFR 483.85, requiring a nursing facility's operating organization to implement a compliance and ethics plan consistent with the regulatory provisions. The proposed rule establishes basic standards that apply to all operating organizations, and then imposes additional standards on those organizations with five or more facilities.

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