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- Health care providers who received Medicaid payments of 5 million dollars or more directly from the Michigan Department of Health and Human Services (“MDHHS”) from January 1, 2015 to December 31, 2015, are required to have policies in place for employees, contractors and agents that contain detailed information about the federal False Claims Act, state laws pertaining to false claims, and whistleblower protections.
- MDHHS requires providers to complete a “Certification of Compliance with Section 6032 of the Deficit Reduction Act (DRA) of 2005 (Employee Education About False Claims Recovery)” within 60 days of receiving this letter from MDHHS, which was issued on May 26, 2016, and will likely be received by Michigan Medicaid providers in early June.
- Medicaid providers who do not ensure compliance with these requirements may be ineligible to receive Medicaid payments.
Section 6032 of the Deficit Reduction Act of 2005 (“DRA”) requires health care providers who receive Medicaid reimbursements of 5 million dollars a year or more to have certain written policies in place for their employees, contractors, and agents. These policies must contain detailed information about the federal False Claims Act, administrative remedies for false claims and statements, state laws pertaining to civil or criminal penalties for false claims and statements, and whistleblower protections. Additionally, employees must be educated on these laws. Compliance with the DRA is a condition of receiving Medicaid payments.
If you are a Michigan Medicaid provider, and you receive Medicaid reimbursements directly from the Michigan Department of Health and Human Services (“MDHHS”) in amounts greater than the 5 million dollar a year threshold, then MDHHS requires you to attest that you are in compliance with the above described requirements on an annual basis. You must complete this attestation within 60 days of receipt of this letter from MDHHS, which likely will be received by Michigan Medicaid providers in early June.
Providers need only count amounts received directly from MDHHS in calculating the 5 million dollar amount. Providers should not count amounts received through a contract with a Michigan Medicaid Managed Care Organization (“MCO”) when calculating the 5 million in payments. Note, however, that simply because a provider does not need to complete the annual attestation does not mean that it will necessarily avoid having to put appropriate policies in place. MCOs are considered covered entities themselves, and are required by law to require their contractors to independently comply with the education requirements. Thus, any provider with a MCO contract would be required to have the requisite policies in place – whether or not they were required to attest to MDHHS.
You should ensure that your entity has in place the required written policies and procedures for all of its employees, contractors and agents. If our firm has handled your labor and employment work, and we drafted or edited your employee handbook, then you should be in compliance with the DRA, as the required DRA language is included in our standard employee policies. Additionally, if you use our firm for your vendor contracting, you should be in compliance as well, since we make sure to put the required DRA language in contracts we review or draft.
If you do not believe you have all the required DRA language in place for your employees, contractors and agents, please contact us immediately, as we can assist you in complying with this requirement prior to the 60 day attestation deadline.
Answers to Frequently Asked Questions (FAQs) on the DRA requirements have been prepared by CMS, and may be accessed HERE.
In addition, you may contact Carol Rolf (Rolf@ROLFLaw.com), Aric Martin (Martin@ROLFLaw.com) at 866-495-5608 for more information. Employment policies may be obtained from Robert Pivonka (Pivonka@ROLFLaw.com) and contract language may be obtained from Aric Martin.
Please note that this alert is intended to be informational only, and is not intended to be nor should it be relied upon as legal advice. Rolf Goffman Martin Lang LLP will not be responsible for any actions taken or arrangements structured based upon this alert. The receipt of this alert by an organization that is not a current client of Rolf Goffman Martin Lang LLP does not create an attorney-client relationship between the recipient and the law firm.
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