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Date ArticleType
12/1/2019 Regulatory
CMS Final Rule – Binding Arbitration & Compliance Check

In July 2019, the Department of Health and Human Services (HHS) published a final rule establishing requirements related to the use of binding arbitration agreements.  The final rule amends the requirements that providers in Long-Term Care must meet in order to participate in Medicare and/or Medicaid. 

Conduct a compliance audit to ensure your residency agreements meet the following requirements: 

  • Residency agreements must be explained to the resident and or the legal representative in a form and manner that is fully understood. The agreement also requires a signed acknowledgement that he/she understands the agreement.
  • The agreement cannot contain language that prohibits or discourages communication with federal or state officials.
  • The agreement provides for a selection of a neutral arbitrator and venue of convenience by all parties.
  • The agreement must include the right to resend the agreement within 30 days of signing it.
  • Signing a binding arbitration agreement cannot be forced or conditional for admission to the facility or to continue to receive services and care.
  • Records of arbitration agreements and final decisions must be kept for a period of five (5) years and made available upon request of CMS or its designee.

The final rule can be found here. AHCA's updated model arbitration agreement and other related resources are available here. You can also listen to an AHCA webinar on complying with the regulation here.  

Please contact Lori Davenport at ldavenport@ihca.org if you have any questions.