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Filed Under:Health Insurance, Medicare

Feds propose state LTC ombudsman program regs

Two arms of the U.S. Department of Health and Human Services (HHS) are trying to complete a regulatory project that HHS started in 1994 and never got around to finishing.

The Administration on Aging (AoA) and the Administration for Community Living (ACL) have published proposed regulations on implementation of the version of the State Long-Term Care Ombudsman program (RIN 0985-AA08) that was included in the revision of the Older Americans Act passed in 1992.

The comments are set to appear in the Federal Register Tuesday.

Comments will be due 60 days after the official Federal Register publication date.

State ombudsman programs are supposed to help users of long-term care (LTC) services and their relatives improve the quality of the services and resolve disputes with providers.

State ombudsman programs have been operating use 1988 regulations written to implement an older version of the Older Americans Act, officials said.

When researchers at the Institute of Medicine, an official government medical advisory arm, looked at the ombudsman program in 1995, they suggested that coming up with final regulations for the ombudsman program would be one way to improve it.

Completing the regulations should help give AoA and ACL officials give clear and consistent guidance on how to run the ombudsman programs, officials said in a preamble to the proposed regulations.

In the new draft regulations, officials address the roles and responsibilities of ombudsman programs and related programs; potential conflicts of interest between ombudsman programs and other programs; how ombudsman programs can service LTC facility residents; and training and certification standards for ombudsman office representatives.

In connection with privacy, for example, officials noted that some LTC providers and state agencies have refused to give LTC facility records ombudsman program officials due to concerns about Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy rules.

A section of the new proposed regulations clarifies that the state "has a responsibility to establish policies and procedures consistent with this HIPAA guidance in order to provide representatives of the [ombudsman's] office with appropriate access to resident records," officials said.

See also:


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Nichole Morford

Nichole Morford
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