By Tom Jegou, CPP, Compliance Expert at SmartLinx Solutions
With a new administration in place, many changes are being proposed for the American healthcare system.
With the passing of the American Health Care Act (AHCA) in the House in May, the bill now resides in the Senate for further review, revision, and voting. Nevertheless, while Senate legislators work on the bill, a question is still left hanging in the air:
What does this all mean for long-term care and healthcare providers?
It is irrefutable that the AHCA, if passed, will have a large impact on the long-term care industry. With changes in Medicare and Medicaid funding currently worked into the bill, and the possibility for changes in facility reporting still looming, understanding its implications can be challenging. While news of the AHCA is creating urgency, it is important to stay focused on understanding the actions you should be taking to remain compliant now.
Here are three things to keep in mind to ensure you’re on track to maintain compliancy as we wait for the future of the AHCA to become clearer:
1. PBJ reporting is still required and is not likely to be impacted by the AHCA. Payroll-Based Journals appear to be here to stay, which means remaining compliant in your reporting will continue to be essential to the success of any skilled nursing facility. Your PBJ will need to be reported accurately to avoid failure or mistakes in reporting, which can lead to a black mark being placed by your facility’s name on the Medicare.gov database.
Markings made on the Medicare.gov website indicating PBJ compliancy:
Green indicates a compliant status.
Black indicates non-compliance.
2. 1095-C reporting is still required and will most likely remain a requirement, even if the AHCA is passed into law. The AHCA in its current form would effectively repeal the employer mandate by reducing fines to $0 for not offering healthcare coverage. However, 1095-C reporting is still required, and inaccuracies in reporting can generate a $260-per-person fine; failure to report can make that fine jump to $530 per person!
3. The ACA and all its mandates are still in effect. Until the AHCA passes in the Senate and is signed by the president, the Affordable Care Act and all its requirements are still in effect, and should be presumed to be so until the bill is signed into law. It is imperative to remain compliant with the ACA to avoid any penalties.
As the AHCA is debated in the Senate, changes are to be expected, including some that may impact reporting requirements. The SmartLinx Research Team is here to keep you up to date on all changes to the bill and help you maintain compliancy.