OIG to Look at Medicare Part D Payments in SNF Stays and Nursing Home Background Checks (1/21)

By OIG - January 15, 2021

Medicare Part D Payments During Covered Part A SNF Stay

Medicare Part A prospective payments to skilled nursing facilities (SNFs) cover most services, including drugs and biologicals furnished by the SNF for use in the facility for the care and treatment of beneficiaries. Accordingly, Medicare Part D drug plans should not pay for prescription drugs related to posthospital SNF care because these drugs are already included in the consolidated payment for Part A SNF stays. We will determine whether Medicare Part D paid for drugs that should have been paid under Part A SNF stays.

 

Announced or Revised

Agency

Title

Report Number(s)

Expected Issue Date (FY)

January 2021

Centers for Medicare and Medicaid Services

Medicare Part D Payments During Covered Part A SNF Stay

W-00-21-35866

2022

 

Background Checks for Nursing Home Employees

Federal regulation 42 CFR 483.12(a)(3) provides beneficiaries who rely on long-term care services with protection from abuse, neglect, and theft by preventing prospective employees with disqualifying offenses from being employed by these care providers and facilities. The National Background Check Program was enacted by legislation in 2010 to assist States in developing and improving systems for conducting Federal and State background checks. Prior OIG work has shown that not all States complied with the National Background Check Program for Long-Term Care Providers. We will determine whether Medicaid beneficiaries in nursing homes in selected States were adequately safeguarded from caregivers with a criminal history of abuse, neglect, exploitation, mistreatment of residents, or misappropriation of resident property, according to Federal requirements. 

 

Announced or Revised

Agency

Title

Report Number(s)

Expected Issue Date (FY)

January 2021

Centers for Medicare and Medicaid Services

Background Checks for Nursing Home Employees

W-00-21-31553

2022