[Federal Register Volume 63, Number 243 (Friday, December 18, 1998)]
[Notices]
[Pages 70137-70138]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-33566]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of Inspector General
Solicitation of Information and Recommendations for Developing
OIG Compliance Program Guidance for the Nursing Home Industry
AGENCY: Office of Inspector General (OIG), HHS.
ACTION: Notice.
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SUMMARY: This Federal Register notice seeks the input and
recommendations of interested parties into the OIG's development of a
compliance program guidance for the nursing home industry and its
providers and suppliers, especially those serving Medicare and Medicaid
beneficiaries. Many providers and provider organizations have expressed
an interest in better protecting their operations from fraud and abuse.
The OIG has developed guidances for hospitals, clinical laboratories,
home health agencies and third-party medical billing companies.
Currently, the OIG has under development compliance program guidance
for the durable medical equipment, prosthetic and orthotic supply
industry and Medicare+Choice organizations with coordinated care plans.
In order to provide a clear and meaningful guidance to those segments
of the health care industry involved in the ownership and operation of
nursing care facilities, the OIG is soliciting comments,
recommendations and suggestions from concerned parties and
organizations on how best to develop a compliance program guidance and
reduce fraud and abuse within the nursing home industry.
DATES: To assure consideration, comments must be delivered to the
address provided below by no later than 5 p.m. on February 16, 1999.
ADDRESSES: Please mail or deliver your written comments,
recommendations and suggestions to following address: Office of
Inspector General, Department of Health and Human Services, Attention:
OIG-5-CPG, Room 5246, Cohen Building, 330 Independence Avenue, SW,
Washington, DC 20201.
We do not accept comments by facsimile (FAX) transmission. In
commenting, please refer to the file code OIG-5-CPG. Comments received
timely will be available for public inspection as they are received,
generally beginning approximately 3 weeks after publication of a
document, in Room 5541 of the Office of Inspector General at 330
Independence Avenue, SW, Washington, DC 20201 on Monday through Friday
of each week from 8 a.m. to 4:30 p.m.
FOR FURTHER INFORMATION CONTACT: Stephen Davis, Office of Counsel to
the Inspector General, (202) 619-2078.
SUPPLEMENTARY INFORMATION: The development of compliance program
guidances continues as a major OIG initiative as a vehicle for engaging
the private health care community in an effort to reduce fraud and
abuse. This nursing home guidance represents another step in the OIG's
plan to encourage the implementation of compliance programs in specific
segments of the health care industry.1 As in the past, this
guidance is designed to provide clear direction and assistance to
Medicare and Medicaid nursing home providers, their owners and
suppliers, who are interested in reducing and eliminating fraud and
abuse within their organizations.
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\1\ See 62 FR 9435 (March 3, 1997) for clinical laboratories, as
amended in 63 FR 45076 (August 24, 1998); 63 FR 8987 (February 23,
1998) for hospitals; 63 FR 42410 (August 7, 1998) for home health
agencies, and for third party medical billing companies appearing
elsewhere in this Federal Register. The guidance can also be found
on the OIG web site at http://www.dhhs.gov/progorg/oig.
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The guidance represents the culmination of the best suggestions and
recommendations from the OIG and from representatives of the private
health care community on how providers can most effectively establish
internal controls and implement monitoring procedures to identify,
correct and prevent fraudulent and wasteful activities. As stated in
previous guidances, these guidelines are not mandatory for providers,
nor do they represent an exclusive document of advisable elements of a
compliance program.
In an effort to formalize the process by which the OIG receives
public comments in connection with compliance program guidances, the
OIG is seeking, through this Federal Register notice, formal input from
interested parties as the OIG begins developing the compliance program
guidance for Medicare and Medicaid covered nursing home facilities,
their providers and suppliers. The OIG considers all comments,
recommendations and suggestions submitted and received by the time
frame indicated above.
The OIG anticipates that the nursing home guidance will contain
seven elements that the OIG considers necessary for a comprehensive
compliance program. These seven elements have been discussed in our
previous guidances and include:
The development of written policies and procedures;
[[Page 70138]]
The designation of a compliance officer and other
appropriate bodies;
The development and implementation of effective training
and education programs;
The development and maintenance of effective lines of
communication;
The enforcement of standards through well-publicized
disciplinary guidelines;
The use of audits and other evaluation techniques to
monitor compliance; and
The development of procedures to respond to detected
offenses and to initiate corrective action.
The OIG would appreciate specific comments, recommendation and
suggestions on (1) risk areas for the nursing home industry, and (2)
aspects of the seven elements contained in previous guidances that may
need to be modified to reflect the unique characteristics of the
nursing home industry. Detailed justifications and empirical data
supporting suggestions would be appreciated. The OIG is also hopeful
that any comments, recommendations and input be submitted in a format
that addresses the above topics in a concise manner, rather than in the
form of comprehensive draft guidance that mirrors previous guidances.
Dated: December 14, 1998.
June Gibbs Brown,
Inspector General.
[FR Doc. 98-33566 Filed 12-17-98; 8:45 am]
BILLING CODE 4150-04-P
