(A)
Definitions.
(1)
"Fines" means civil money penalties (CMPs) and other
assessments imposed against a NF as a remedy for deficiencies or a cluster of
deficiencies that were not substantially corrected before a
survey.
(2)
"Interest" means the interest rate determined by the
tax commissioner on the fifteenth day of October each year by rounding the
federal short-term rate to the nearest whole number per cent and adding three
per cent. This is the interest rate per annum used in computing the interest
that accrues during the following calendar year.
(B)
Procedure for
collection of fines imposed by the centers for medicare and medicaid services
(CMS).
(1)
If
CMS has been unable to collect a CMP fine directly and notifies the Ohio
department of medicaid (ODM), ODM will attempt to collect the
fine.
(2)
ODM will inform the NF, via certified mail, of the
following available payment options:
(a)
Lump sum
payment.
A lump sum payment, including any
interest accrued, from the provider; or
(b)
Periodic
payments.
Periodic payments, including any
interest accrued, in accordance with a schedule approved by ODM for a period
not to exceed twelve months; or
(c)
Medicaid payment
offset.
Following the date on which the fine
plus interest becomes due, an appropriate reduction to medicaid payments made
to the provider for care rendered to medicaid eligible residents in accordance
with a schedule approved by ODM for a period not to exceed twelve months;
or
(d)
Attorney general's office (AGO).
If the facility is no longer active in
the medicaid program, the fine may be referred to the AGO for collection in
accordance with section
131.02 of the Revised
Code.
(3)
Not later than ten days after notification, the NF is
responsible for selecting a payment option and advising ODM in
writing.
(4)
If the NF fails to adhere to the terms of the payment
agreement or fails to select a payment option within ten days, ODM will
immediately implement collection from an actively participating facility by
medicaid payment offset(s). If a facility is not actively participating in the
medicaid program, the fine will be referred to the AGO for
collection.
(5)
The fine and any interest collected from the NF will be
retained in the resident protection fund.
(6)
ODM will notify
CMS in writing when the CMP fine has been collected in full.
(C)
Uses of the resident protection fund.
(1)
Proceeds from all
fines, including interest collected, are deposited in the state treasury to the
credit of the resident protection fund.
(2)
Monies in the
resident protection fund may only be used in accordance with
42
CFR 488.433 and
488.442
(October 1, 2019) for activities that protect or improve the quality of care or
quality of life for residents of NFs.
(D)
Management of the
resident protection fund.
ODM will provide budgetary, accounting,
and other related management functions for the resident protection fund. When
medicaid payment offset is used as a means of collection, the amount equal to
the reduction in medicaid payments will be deposited to the credit of the
resident protection fund.
(E)
Disbursement of
funds.
Upon CMS approval of disbursement of
monies in accordance with paragraph (C) (2) of this rule, a purchase order will
be created by ODM against which invoices or intrastate transfer vouchers are
submitted, or, in the event of an emergency at a nursing facility, a state
issued payment card will be used.
(F)
The provisions of
this rule are applicable only to the extent that monies are available in the
resident protection fund.
Replaces: 5160-3- 03.2
Notes
Ohio Admin. Code
5160-3-03.2
Effective:
8/15/2020
Five Year Review (FYR) Dates:
08/15/2025
Promulgated
Under: 119.03
Statutory
Authority: 5162.02
Rule
Amplifies: 5162.66
Prior
Effective Dates: 01/01/1995, 07/01/2002, 07/01/2005, 01/01/2009,
03/22/2015
