Long-Term Care Survey Alert
What Do You Think?
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Question: What do government authorities consider to be "plan steering" under Part D and is it against the law or survey regulations?
Facilities that steer residents to a particular prescription drug plan are violating the law, says Harvey Tettlebaum, an attorney with Husch & Eppenberger in Jefferson City, MO. "Which particular law depends on whether the facility receives something of value for steering residents to a particular facility, which would be an anti-kickback law violation," he adds.
In addition, a facility could violate residents' rights by not allowing them to choose from PDPs that meet the Centers for Medicare & Medicaid Services' criteria, according to Tettlebaum.
Facilities are free to educate residents about the various plan options, but cannot direct the person to sign up for a particular plan.
Know the List of Don'ts:
According to Tettlebaum, facilities should not engage in these actions:
(1) accept compensation from a PDP, MA-PD or long-term care pharmacy to enroll residents into a particular plan or set of plans;
(2) state directly that residents must choose one plan;
(3) accept a completed Part D enrollment application and put it in the mail for the resident; or
(4) push the send button on an electronic application.
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