National Association for Home Care & Hospice Issues Public Comment on Financial Crimes Enforcement Network Proposed Rule
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Since 1982, the
In response to the request for comments in the advance notice of proposed rulemaking (ANPRM) for the implementation of the Corporate Transparency Act (CTA), NAHC offers the following comments and recommendation regarding question number 7 in the ANPRM.
7) Are there any categories of entities that are not currently subject to an exemption from the definition of "reporting company" that FinCEN should consider for an exemption pursuant to this authority, and if so, why?
NAHC believes that federally regulated health care institutions, specifically Medicare certified home health care and hospice agencies, should explicitly be exempted from the definition of "reporting company". These organizations are heavily regulated by the
Any healthcare organization wishing to participate in the federal health care programs must submit a provider enrollment application to a CMS contractor. CMS has instituted a number of protections to prevent fraudulent actors from entering into federal health care programs through the provider enrollment process, including, risk-based screening categories for applicants and extensive reporting requirements for provider and supplier affiliations on initial applications and revalidations of the provider agreement.
Risk based screening for home health agencies requires that providers undergo fingerprint-based criminal background checks and on-site validation visits for initial applications, with subsequent on-site visits for revalidation applications. Hospice agencies must undergo an on-site visit for initial and revalidation applications.
Under the provider enrollment reporting requirements, Medicare, Medicaid, and
* uncollected debt;
* has been or is subject to a payment suspension under a federal health care program;
* has been or is excluded by the
* has had its Medicare, Medicaid, or CHIP billing privileges denied or revoked
Additionally, Medicare certified home health and hospice providers are statutorily required to be surveyed for compliance with the federal conditions of participation standards once every three years. These surveys include an intensive onsite review of the agency's operations by a Medicare contracted surveyor. Deficiencies in complying with the standards in home health can result in an algorithm of corrective actions along with civil money penalties of up to
Home care is also provided by non-Medicare/Medicaid certified agencies that in some states are required to meet rigorous state licensure requirements to credential owners and ensure quality of care is provided in a consistent manner. States that license home care agencies survey these providers at regular intervals to ensure licensure requirements continue to be met and enforce accountability through maintaining licensure.
In addition to protecting health care programs from fraudulent and poor performing providers these program integrity initiatives would also assist in capturing money laundering schemes.
NAHC is concerned that requiring certified home health and hospice providers, and state licensed home care providers to comply with CTA reporting requirements would be redundant and unnecessary in light of the existing federal and state oversight to which these organizations are subject.
Recommendation: NAHC urges the
Thank you for the opportunity to submit these comments.
Sincerely,
V.P. for Regulatory Affairs
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The proposed rule can be viewed at: https://www.regulations.gov/document/FINCEN-2021-0005-0001
URL:
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