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The CMP Fund was created by the United States Social Security Act of 1987 from penalty monies collected from nursing homes. The purpose of the fund is to provide funding for projects designed to reduce deficient practices of certified nursing facilities. The Centers for Medicare and Medicaid Services (CMS) retains a portion of the monies and redistributes the rest to the states.
The State of Oklahoma created a designated fund in 2013 to hold and appropriate the redistributed monies in accordance with CMS guidance “for the protection of the health or property of residents of nursing facilities” (O.S. 63 §63-1-107.4). To protect the health of nursing home residents is to improve the quality of care, which includes clinical and organizational aspects. Please reference the funding domains and focus areas to learn more about the Program’s targeted approach to quality improvement.
State Authority for Oklahoma’s CMP fund
States adopted a variety of models for their CMP Program structure. Some states created a new agency for quality improvement projects with its own staff. Some states housed the program as part of the state’s Medicaid program. Other states, like Indiana, linked the program to their CMS Survey and Certification Program that is often a part of the state health agency. In Oklahoma, the CMP Program resides within the administration divisions of the Protective Health Services at the Oklahoma State Department of Health. Protective Health Services has a diverse spectrum of responsibilities to provide citizen and consumer protection per state mandate. When the CMP fund was created, Oklahoma housed the fund with OSDH Protective Health Service (PHS), where the program remains today.
The OSDH is also the designated CMS State Survey Agency for Health Facility Certification, but the Program is organizationally separated from enforcement functions to purposefully support improvements in nursing homes rather than support or negate any enforcement function. The Program does support joint provider/surveyor trainings to foster shared knowledge, interpretations, and trust.
In 2013 the Oklahoma Legislature passed legislation establishing a state fund to receive CMP funds and designate the OSDH to administer the fund in compliance with the federal guidance outlined in 42CFR §488.433. The fund has been administered by the OSDH Protective Health Services Administration since the fund’s inception. (Oklahoma Statute 63, §63-1-107.4) This statute established a revolving fund designated the "Oklahoma Department of Health Civil Monetary Penalty Revolving Fund" to receive monetary collections under 42 U.S.C. § 1396r. The Oklahoma Statute follows.
§63-1-107.4. Oklahoma Department of Health Civil Monetary Penalty Revolving Fund.
A. There is hereby created in the State Treasury a fund for the State Department of Health to be designated the "Oklahoma Department of Health Civil Monetary Penalty Revolving Fund". The fund shall be a continuing fund, not subject to fiscal year limitations. It shall consist of monies received by the State Department of Health which emanate from fines and assessments against Oklahoma nursing homes and other long-term and non-long-term care facilities found to be noncompliant with federal conditions of participation.
B. All monies accruing to the credit of the fund are hereby appropriated and may be budgeted and expended by the State Department of Health at the discretion of the Commissioner of Health for the protection of the health or property of residents in nursing facilities.
C. All expenditures shall be in compliance with requirements of the Centers for Medicare and Medicaid Services. Expenditures from the fund shall be made upon warrants issued by the State Treasurer against claims filed as prescribed by law with the Director of the Office of Management and Enterprise Services for approval and payment.
D. The Commissioner of Health may request the Director of the Office of Management and Enterprise Services to transfer monies between the Oklahoma Department of Health Civil Monetary Penalty Revolving Fund and any other fund of the Department, as needed for the proper expenditure of funds.
Added by Laws 2013, c. 258, § 1, eff. Nov. 1, 2013.
Civil Monetary Penalty Fund Program
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