Notices and Beneficiary Appeal Rights in Skilled Nursing Facilities Centers for Medicare & Medicaid Services (CMS) Satellite Broadcast and Webcast

Transcription

1 Ntices and Beneficiary Appeal Rights in Skilled Nursing Facilities Centers fr Medicare & Medicaid Services (CMS) Satellite Bradcast and Webcast Friday June 19, :00-1:45 PM EDT PLEASE ADJUST TIMES FOR YOUR TIMEZONE Gal The gal f tday s bradcast is t review the different types f discharge and liability ntices that are issued by prviders in Skilled Nursing Facilities. This prgram is a pre-taped presentatin that explains under what circumstance prviders are bligated t give each type f ntice. The prgram will als explain the expedited review prcess. Finally, there is a presentatin n hw surveyrs are t cmplete the review fr facility cmpliance with the ntice requirements in bth the traditinal survey prcess and the Quality Indicatr Survey. Objectives After viewing this prgram, participants will be able t: Identify the fur types f ntices including the denial letter, the SNF Advance Beneficiary Ntice, the Revised ABN and the Generic Ntice; Explain under what circumstance the prvider is bligated t give each type f ntice; Explain the expedited review prcess, and Explain hw the ntice requirement is surveyed under bth the traditinal survey prcess and the Quality Indicatr Survey. Target Audience Federal and State surveyrs, nursing hme prviders and Medicare beneficiaries. Mderatr: Jeane Nitsch, JD, MS, MSW, LCSW-C Presenters: Charlayne D. Van, JD CMS/Center fr Drug and Health Plan Chice/Divisin f Appeals CMS/ Medicare Enrllment and Appeals Grup/ Divisin f Appeals Nurse Cnsultant 1

2 Registratin and Viewing Instructins Surveyrs: Individual registratin is available n the CMS Survey and Certificatin Training Grup website: If yu are a new user t this website, yu will need t create a new accunt. Registratin is required t btain training certificates. Prviders: T view a live r archived bradcast prviders d nt need t register, simply click n Satellite Bradcast r Archived Webcast. Webcast Infrmatin This prgram will have a live webcast and will be available as an archived webcast fllwing June 19 at Registratin is als required t view the archived satellite bradcast and t btain training certificates Satellite Technical Specificatins This bradcast will be available nly n CMS s digital netwrk. Specific satellite technical specificatins will are available at r can be btained by calling Handuts There are three handuts fr this bradcast. 2

3 Agenda Ntices and Beneficiary Appeal Rights in Skilled Nursing Facilities Multimedia Satellite Bradcast June 19, 2009 On June 19, 2009, 1:00-1:45 p.m. EDT, the Centers fr Medicare & Medicaid Services will bradcast a 45 minute presentatin via satellite and Internet. The shw includes a discussin cncerning several aspects f discharge and liability ntices that are issued by prviders in Skilled Nursing Facilities. The shw fcuses n explaining the types f ntices, when the ntices shuld be issued and a beneficiary s appeal rights. The shw als includes an verview f hw surveyrs are t cmplete the review fr facility cmpliance with the ntice requirements under bth in the traditinal survey and in the Quality Indicatr Survey. The shw shuld be f particular interest t Federal and State surveyrs, nursing hme prviders and Medicare beneficiaries. Presenters and Tpics Apprximate Time Tpic Presenter 1:00-1:03 Welcme Intrductin t Shw Jeane Nitsch- Mderatr 1:03-1:06 Histry and Review f 4 Ntice Structure Jeane Nitsch- Mderatr Charlayne Van, JD CMS/Center fr Drug and Health Plan Chice/Divisin f Appeals 1: 06-1:12 Presentatin n Each Type f Ntice (Denial Letters and the SNFABN, the Revised ABN, the Ntice f Exclusin frm Medicare Benefits, and the Generic Ntice); Explanatin n When Each Ntice Shuld Be Issued; and Updates Regarding the Ntices. 1:13-1:19 Presentatin n the Ntice f Medicare Prvider Nncverage (Generic Ntice) and the Expedited Review Prcess Charlayne Van, JD CMS/Center fr Drug and Health Plan Chice/Divisin f Appeals CMS/ Medicare Enrllment and Appeals Grup/ Divisin f Appeals 3

4 1:19 1:24 Review f Infrmatin and Qs & As Jeane Nitsch- Mderatr Charlayne Van, JD CMS/Center fr Drug and Health Plan Chice/Divisin f Appeals CMS/ Medicare Enrllment and Appeals Grup/ Divisin f Appeals 1:24 1:29 Reviewing fr Cmpliance under the Traditinal Survey Prcess 1:29 1:38 Reviewing fr Cmpliance under the Quality Indicatr Survey Nurse Cnsultant 1: 38 1:43 Review f Infrmatin and Qs & As Jeane Nitsch- Mderatr Nurse Cnsultant 1:43 1:45 Wrap-up Jeane Nitsch- Mderatr 4

5 Bis Jeane Nitsch, JD, MS, MSW, LCSW-C Jeane Nitsch wrks in the at the Centers fr Medicare & Medicaid Services. Her primary rle includes regulatry interpretatin and the develpment and implementatin f natinal plicies related t the survey and certificatin f nursing hmes. Prir t jining CMS in 1998, she wrked as the Directr f Admissins and Scial Wrk in a hspital-based Sub-acute unit. Her experience has primarily been in nursing hmes, as well as cntinuing care retirement cmmunities and assisted living facilities. Ms. Nitsch earned a Master f Scial Wrk degree specializing in Aging frm the University f Maryland Schl f Scial Wrk and she hlds a Master f Science degree in Health Care Management frm the University f Maryland University Cllege. She recently cmpleted her Juris Dctr at the University f Maryland Schl f Law with a Certificate in Health Law. Charlayne D. Van, JD Charlayne Van wrks in the Divisin f Appeals. Her primary rle includes serving as the senir plicy analyst and natinal subject matter expert n Advance Beneficiary Ntice (ABN) plicy. Charlayne is als respnsible fr the develpment, analysis, and implementatin f plicies related t cnsumer rights and prtectins acrss prvider settings under the Medicare fee-fr-service and managed care prgrams. Prir t jining CMS in 2005, Charlayne wrked as a human resurces cnsultant fr the Departments f Hmeland Security and Health & Human Services. She earned a Bachelr f Arts degree in Plitical Science frm Hward University. She cmpleted her Juris Dctr at the University f Baltimre Schl f Law. Janet Miller wrks in the Divisin f Appeals at the Centers fr Medicare & Medicaid Services. Her primary area f expertise is the fee-fr-service expedited review prcess fr service terminatins. Prir t jining CMS in 2002, she wrked as a Prgram Analyst fr the Office f the Inspectr General f the Department f Health and Human Services cnducting natinal prgram evaluatins f the Medicare claims appeal prcess. Ms. Miller hlds a bachelr s degree in plitical science and ecnmics frm the University f Minnesta and a master f public plicy degree frm the University f Minnesta s Humphrey Institute f Public Affairs. Beverly is a registered nurse wh has been emplyed as a nurse cnsultant with CMS fr ver 10 years. Prir t cming t CMS, Beverly wrked fr ver 17 years as a surveyr and supervisr with the Minnesta Department f Health. At CMS, Beverly wrks in the in the Survey and Certificatin Grup. She wrks n the lng term care survey prcess and specializes in quality f care. She was the c-prject fficer fr a cntract t update interpretive guidance fr surveyrs and develp severity guidance fr several key regulatry tags frm 2000 thrugh September In 2005, Beverly received the Thmas Stewart Funders Award presented by the Natinal Pressure Ulcer Advisry Panel fr her wrk in the develpment f the F314 pressure ulcer guidance, which was released in Nvember, She has been actively invlved in the develpment and implementatin f the new Quality Indicatr Survey. Peggy E Williams wrks in the at the Centers fr Medicare and Medicaid Services. She is a Master QIS Trainer and key member f the CMS QIS team, helping in the further develpment and refinement f the QIS. Peggy is als a member f the CMS Culture Change team, which is planning the 2010 Natinal Sympsium n the nursing hme dining requirements in cllabratin with the Pineer Netwrk. Prir t jining CMS, Peggy wrked as a Master QIS Trainer fr the University f Clrad and CIBER, Inc, and with Nursing Hme Quality and the state survey agencies implementing the QIS. Her career in lng-term care started as a scial wrker in Suth Dakta nursing hmes and cntinued with the Suth Dakta Department f Health as a nursing hme surveyr and state training crdinatr in which she prvided nging training fr surveyrs and facility staff n state and federal regulatins and the RAI/MDS. She was als a funding member f the Suth Dakta Culture Change Calitin. Peggy earned a Master f Science in Health Care Administratin frm the University f Suth Dakta and a Bachelr f Arts in Scial Wrk frm Augustana Cllege in Siux Falls, SD. 5

6 TECHNICAL FACT SHEET DATE: June 19, 2009 TEST TIME: 12:30 1:00 p.m. EDT 11:30 12:00 p.m. CDT 10:30 11:00 a.m. MDT 9:30 10:00 a.m. PDT PROGRAM TIME: 1:00 1:45 p.m. EDT 12:00 12:45 p.m. CDT 11:00 11:45 p.m. MDT 10:00-10:45 p.m. PDT SATELLITE TROUBLE NUMBER: CMS Digital Netwrk: Channel 712 6