Define: Obra

Obra refers to the Omnibus Budget Reconciliation Act, a federal law enacted in 1987 that primarily focuses on healthcare and long-term care provisions.

Some key provisions of Obra include the establishment of nursing home quality standards, mandatory employee background checks, Medicaid fraud and abuse prevention measures, and the creation of the Medicare Prescription Drug Benefit.

Obra sets forth specific requirements for nursing homes, such as maintaining a certain level of staffing, conducting regular assessments of residents’ needs, and ensuring the provision of quality care. Non-compliance with Obra regulations can result in penalties and loss of Medicare/Medicaid certification.

Obra mandates that nursing homes conduct comprehensive background checks on all prospective employees to ensure they do not have a history of abuse, neglect, or exploitation. This measure aims to protect vulnerable residents from potential harm.

Obra includes provisions to prevent and detect Medicaid fraud and abuse, such as requiring healthcare providers to establish compliance programs, imposing penalties for fraudulent activities, and enhancing the government’s ability to investigate and prosecute offenders.

Obra introduced the Medicare Part D program, which provides prescription drug coverage to Medicare beneficiaries. This benefit allows individuals to obtain necessary medications at reduced costs, enhancing access to essential healthcare services.

Nursing homes cannot refuse admission solely based on Obra regulations. However, they must comply with the requirements set forth by Obra to maintain their certification and eligibility for Medicare/Medicaid reimbursement.

Penalties for non-compliance with Obra regulations can vary, but they may include fines, suspension or revocation of Medicare/Medicaid certification, and potential criminal charges for serious violations.

Individuals can report suspected Obra violations to the appropriate regulatory agencies, such as the Centers for Medicare & Medicaid Services (CMS) or state health departments. These agencies have mechanisms in place to investigate and address reported concerns.

While Obra primarily focuses on nursing homes, it also applies to other healthcare providers that participate in Medicare and Medicaid programs. These providers must adhere to the relevant Obra provisions to maintain compliance and eligibility for reimbursement.