Steven Baruch - Health Care Compliance Association

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Mobility disabilities: A technical assistance manual for health care providers ...continued from page 7 provide that assistance will contribute to providing safe and accessible health care for people with mobility disabilities. HEALTH CARE COMPLIANCE ASSOCIATION’S 15 th Annual COMPLIANCE INSTITUTE April 10–13, 2011 Orlando, FL The Walt Disney World Swan and Dolphin Resort EARLY BIRD REGISTRATION Register by or on January 6, 2011, and save $575! AGENDA AVAILABLE & REGISTER AT www.compliance-institute.org Conclusion Access to Medical Care for Individuals with Mobility Disabilities provides important and helpful information on how to realize the ADA’s requirement of providing accessible health care to persons with mobility disabilities. It provides guidance in the form of narrative explanation and illustrated examples of accessible medical equipment, room and office configuration, and lifting and transfer equipment and techniques. The publication should prove to be a valuable resource to both health care providers who treat patients with mobility impairments and to those individuals with mobility disabilities who may have encountered obstacles in the past. In addition to the practical tips, the manual can also be a source of authority, if a dispute were to land in court. For example, a mobilityimpaired individual or the Equal Employment Opportunity Commission may cite to the guidance in support of a claim that accessible health care was denied. A provider of medical services may rely on the guidance as evidence that it complied with the obligations imposed by the ADA. Courts may also look to the technical assistance manual as support for its interpretation of what is and is not required by the ADA. 2 However, the guidance is precisely that—guidance. Courts can also reject it. 3 Nonetheless, the manual provides a valuable resource for health care providers who seek to comply with the ADA and ensure that individuals with disabilities receive equal access to care. For those wishing to review the manual in its entirety, it may be viewed at, and downloaded from, the ADA website. 4 n The authors would like to thank Matthew J. McKennan, a law clerk at the Firm, for his assistance in preparing this article. The views and opinions expressed in this article are those of the authors and do not necessarily reflect those of Sills Cummis & Gross PC. 1 See 28 CFR 35.151 (for Title II entities) and 28 CFR Part 36, Subpart D (for Title III entities). Available at www. ada.gov/reg2.html and www.ada.gov/reg3a.html. 2 See, e.g., Buckley v. Consolidated Edison Co. of N.Y., Inc., 127 F.3d 270, 273 (2d Cir. 1997) (referring to EEOC’s Technical Assistance Manual on ADA, appeals court states that “EEOC interpretive guidelines ‘while not controlling upon the courts by reason of their authority, do constitute a body of experience and informed judgment to which courts and litigants may properly resort for guidance.’”) (quoting Meritor Sav. Bank, FSB v. Vinson, 477 U.S. 57, 65 (1986)), vacated on other grounds, 155 F.3d 150 (2d Cir. 1998) (en banc); Shafer v. Preston Mem’l Hosp. Corp., 107 F.3d 274, 280 n.5 (4th Cir. 1997) (same). 3 See, e.g., Parker v. Metropolitan Life Ins. Co., 121 F.3d 1006, 1014 n.5 (6th Cir. 1997) (en banc appeals court declines to adopt interpretation found in Department of Justice Technical Assistance Manual, finding that interpretation inconsistent with regulations and text of ADA), cert. denied, 522 U.S. 1084 (1998); Soileau v. Guilford of Me., Inc., 105 F.3d 12, n.3 (1st Cir. 1997) (“While this court has found reference to the EEOC Compliance Manual to be helpful on occasion…the manual is hardly binding.”). 4 See http://www.ada.gov/medcare_ta.htm. December 2010 8 2011CI_EarlyBird_halfpagevert_ad_2c.indd 1 Health Care Compliance Association • 888-580-8373 • www.hcca-info.org 11/4/2010 12:03:30 PM
RACs are coming to Medicare Advantage, Part D, and Medicaid By Gloryanne Bryant, RHIA, RHIT, CCS, CCDS Editor’s note: Gloryanne Bryant is Regional Managing Director at HIM Northern California, Revenue Cycle, Kaiser Foundation Health Plan Inc & Hospitals. Gloryanne may be contacted by e-mail at Gloryanne.h.bryant@kp.org. Yes, the Recovery Audit Contractors (RACs) are coming to Medicare Advantage Part C, Part D, and Medicaid under the oversight of the Centers for Medicare and Medicare Services (CMS). Section 1902(a)(42)(B)(i) of the Social Security Act, requires states to establish programs to contract with one or more Medicaid RACs for the purpose of identifying underpayments and recouping overpayments under the state plan, and any waiver of the state plan, with respect to all services for which payment is made to any entity under such plan or waiver. Keep in mind that the three-year RAC demonstration program that was launched in California, Florida, and New York in 2005 identified roughly $1 billion in Medicare overpayments, according to CMS reports. State Medicaid programs will have to contract with one or more RACs to identify underpayments and overpayments (and recoup overpayments), including in-state waiver plans. Medicaid RAC compensation will be linked to the payment inaccuracies they are able to identify, both over- and under-payments. The Medicaid RAC audits will be separate from the Medicaid Integrity Program (MIP) audits that are already being completed by Medicaid Integrity Contractors (MICs) in many states. Deborah Taylor, Director and Chief Financial Officer of CMS’ Office of Financial Management, told a Congressional panel in July 1 that CMS is farther ahead in implementing RAC audits for the Medicare Part D prescription program for seniors. The new law requires RACs to ensure plans under Parts C and D: n have anti-fraud policies in effect and to review the effectiveness of such policies; n examine claims for reinsurance payments to determine whether plans submitting the claims incurred costs in excess of allowable reinsurance costs; and n review estimates of prescription drug plans for high-cost beneficiaries submitted by private plans and compare estimates with the number of high-cost beneficiaries actually enrolled in those plans. The start date for these government activities is no later than December 31, 2010 according to the Patient Protection and Affordable Care Act, section 6411. Thus, the health care industry can expect to see a significant expansion of the RAC program. Sen. Tom Carper (D, Del.) chair of the Senate Homeland Security and Governmental Affairs subcommittee on Federal Financial Management, Government Information, Federal Services and International Security, encouraged CMS to meet the December 31 deadline imposed by the Patient Protection and Affordable Care Act. Adding to this RAC expansion is that fact that President Obama signed in July the Health Care Compliance Association • 888-580-8373 • www.hcca-info.org Improper Payments Elimination and Recovery Act of 2010, and this may open the door to more widespread private audits, industry experts say. The law also would add sanctions for programs that do not comply. Your Compliance Committee, RAC Committee, Health Information Management (HIM), and Business Office/Billing leadership should be aware of possible additional external audits. Compliance staff will need to make revisions to their annual work plans to address this expansion as well. So, we will need to monitor this closely and wait patiently for the details so we can plan accordingly. Be sure to include this topic on the agenda for your next compliance meeting. Either way, more time and resources will be needed from providers in the near future. n Resources: Fierce Health Finance (www.fiercehealthfinance.com) RAC Monitor (www.RACmonitor.com) AAPC (www.news.aapc.com) Healthcare Finance News (www.healthcarefinancenews.com) Lexology (www.lexology.com) 1. Committee on Homeland Security and Government Affairs Subcommittee on Federal Financial Management, Government Information, Federal Services, International Security, United States Senate, July 15, 2010. Contact Us! www.hcca-info.org info@hcca-info.org Fax: 952/988-0146 6500 Barrie Road, Suite 250 Minneapolis, MN 55435 Phone: 888/580-8373 To learn how to place an advertisment in Compliance Today, contact Margaret Dragon: e-mail: margaret.dragon@hccainfo.org phone: 781/593-4924 9 December 2010
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Steven Baruch - Health Care Compliance Association

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