Agencies
Services
Provider Notice Issued 04/21/2021
- The family, POA (Power of Attorney), guardian and resident should be consulted in order to collect the most accurate information and determine when a question should be marked yes, no or left blank for unknown.
- Answering a question “no” and leaving an answer blank because the information is unknown are different responses.
- A response should only be marked “no” if it is determined that the answer is actually “no” to one of the questions. For example, the provider determined that a client does not have a bank account.
- If the answer is unknown, then the response should be left blank as unknown. For example, you are not able to determine if a client has a bank account.
- Submitting Medicaid applications with incorrectinformation.
- Selecting “no” to questions on an applicationwithout making an effort to obtain the data prior to submission.
- Submitting TANs with incorrect screeninginformation.
- Falsifying TAN information on an admissionrecord.
- Selecting that an applicant is private pay whenthey are not.
- Failing to report the death or discharge of arecipient.
- Failing to identify a spouse when they areknown or reasonably should be known.
- OIG Code of Conduct for Nursing Home Providers
- CMS Nursing Home Provider Booklet
Date: April 21, 2021
To: Long Term Care Providers - Nursing Facilities (NF),Intermediate Care Facilities for Individuals with Intellectual Disabilities(ICF/IID), Medically Complex for the Developmentally Disabled Facilities(MC/DD), Supportive Living Program (SLP) Providers, and Specialized Mental HealthRehabilitation Facilities (SMHRF)
Re: ProviderResponsibility for Completing Applications
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This notice is to remind long term careproviders that all forms and applications submitted on behalf of a residentneed to be correct and complete. As enrolled Medicaid providers, long term carefacilities must submit Medicaid applications, the 3654 form (AdditionalFinancial Information for Long Term Care Applicants) and all MEDI TAN submissionswith accurate information.
Providers need to exercise due diligence toobtain the requested data and ensure its accuracy prior to applying forMedicaid on behalf of a resident. Since three months backdating is availablewhen submitting a Medicaid application, providers have additional time tocollect the information needed for completion.
When completing an application or the 3654 form:
All information submitted on behalf of aresident by a provider must be correct and complete.
The following list containsexamples of forms and applications which are not considered complete and/orcorrect:
o Data fields cannot be edited after submissionin MEDI (TAN digits, Screening Info, Provider Name and Number)
o Updating TAN data fields require a new TANsubmission.
Whensubmitting an application on behalf of a resident, providers and staff shouldbe mindful of the following attestation in ABE.
Long term care providers, like all enrolledproviders, are expected to act in accordance with all laws, regulations,provider handbooks, guidance, their provider enrollment agreement, and otherapplicable provisions. Failure to do so may subject the provider to referral tothe HFS OIG or other authorities for sanction or further actions.
Please review the below resources for moreinformation on provider expectations.
o https://oig.hhs.gov/authorities/docs/cpgnf.pdf
Questions regarding thisbulletin may be directed to the Bureau of Long Term Care at
1-844-528-8444.
Kelly Cunningham, Administrator
Division of Medical Programs