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HOME HEALTH . THERAPY . PRIVATE DUTY . HOSPICE
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Today’s educational presentation is provided by
The software that powers… HOME HEALTH . THERAPY . PRIVATE DUTY . HOSPICE
877.399.6538 | [email protected] | www.kinnser.com
About the presenter JILL DYER BSN, RN, HCS-D, HCS-O Home Health Executive, Consultant J.I.D. Consulting
About the presenter
SHARON HARDER President C3 Advisors, LLC
More info: c3advisors.com
Today’sFocus! Pa1entRights
! Representa1ves! No1ces! ExerciseofRights! InvolvementinCareandCarePlanning! TransfersandDischarges
! Complaints–Documenta1on,Inves1ga1onandResolu1ons
! OASIS–PrivacyandDataSubmission
BreakingNews–Interpre=veGuidance! DraAInterpre=veGuidancewereissuedonOctober27th
! AvailableathFp://report.nahc.org/wp-content/uploads/2017/10/3819-F-HomeHealthAgency-CoPs_IGs.pdf
! CMSwillnotentertainindividualcomments,butwillacceptcommentsfromNAHC
! CommentsforNAHC’[email protected]
! Today’sslidesmarkedwithshowthemostrecentdraZinterpre1veguidance
KeyDefini=on–Pa=entRepresenta=ve! Pa1ent’slegalrepresenta1veorapa1ent-selectedrepresenta1vewhopar1cipatesincaredecisions
! Canbeafamilymemberorotherpa1entadvocate
! Thepa1entdeterminestherepresenta1ve’sroletotheextentpossible
! Representa1ve’srolebasedonthepa1ent’sstatedpreferenceshouldbedocumentedintherecord
KeyDefini=on–Inadvance
! Meansthattheagency’sstaffmustcompletethetaskpriortoperforminganyhands-oncareorpa1enteduca1on
! Willbeakeydefini1onduringsurveysandmedicalreview
Pa=entRights
“Thepa1entandrepresenta1ve(ifany)havetherighttobeinformedofthepa1ent’srightsinalanguageandmannertheindividualunderstands.TheHHAmustprotectandpromotetheexerciseoftheserights.”
§484.50–Pa=entRightsa) No1ceofrightsb) Exerciseofrightsc) Rightsofthepa1entd) Transferanddischargee) Inves1ga1onofcomplaints
f) Accessibility
§484.50(a)-No=ceofRights! Pa1entandhis/herrepresenta1vemustreceivethefollowinginwri1ngbeforecareisprovided:
! No1ceofPa1entRightsandResponsibili1es! Informa1onconcerningtheagency’stransferanddischargepolicies! Contactinforma1onfortheAdministrator! OASISPrivacyNo1ce
! TheNo1cemustbesignedbythepa1entand/orthelegalrepresenta1veandmaintainedinthepa1ent’srecord
WriUenNo=ceofPa=entRights! Ifthepa1ent’srepresenta1veisnotlegallyappointedviaaguardianship,POAorotherlegalinstrument,informa1onmustbeprovideddirectlytothepa1ent
! Ifthepa1enthasalegallydesignatedrepresenta1ve,thewriFenno1cemustbeprovidedpriortoini1a1ngcare,butthereisoneavailableexcep1ontothe1mingofno1cefortherepresenta1ve
! Ifthepa1entdeclinesno1cetohis/herrepresenta1ve,theagencyshoulddocumentthedeclina1oninthepa1ent’srecord
! Theformthatisusedshouldcontainaconfirma1onstatementthattheNo1ceofPa1entRightshasbeenreceivedbythesigner(s)
LegalRepresenta=veExcep=on! Ifthepa1ent’slegalrepresenta1veisnotavailableandthepa1enthasnotdeclinedtohavetherepresenta1veinformedastopa1entrightsandresponsibili1es,
! TheagencymayprovidethewriFendocumenta1ontothepa1entrepresenta1vewithinfourdaysofini1a1ngcare
! Informa1oncanbeprovidedtotherepresenta1veelectronicallyorinwriFenformthroughthemail
AdministratorContactInfo! Administratorinforma1onisforthepurposeofenablingthepa1entorhis/herrepresenta1vetolodgeacomplaint
! ViewedbyCMSasanessen1alfunc1onofleadership
! Name,businessaddressandbusinessphonenumberoftheadministratorarerequiredasapartoftheno1ceofrights
OASISPrivacyNo=ce! Mustbeinaddi1ontootherrequiredno1cessuchasHIPAAprivacy
! Thisno1ceshouldbeapartoftheoverallPa1entRightsNo1ceandmustbeprovidedanddocumentedattheini1alassessmentvisit
! Appliestoallpa1entsforwhomOASISdataisgathered
VerbalNo=ceofPa=entRights! Verbalno1ceofpa1entrightsandresponsibili1esmustalsobeprovidedintheindividual’sprimaryorpreferredlanguage,
! And,inamannerthattheindividualunderstands
! Ifaninterpreterisneededtofulfillthisrequirement,theservicemustbeofferedwithoutchargetothepa1ent
! Verbalno1cemustbedeliverednolaterthanthesecondvisit
Extenua=ngCircumstances! CMSacknowledgesthatthereare1meswhenitmaybedifficulttofindaninterpreterforlesscommonlanguages
! CMSexpectsthattheagencywillexhaustallavenuesincludingtelephonictransla1onservices,videoconferencingoronlinetransla1onofwriFendocuments
! Suchop1onsareacceptableaslongastheymeetthepa1ent’sneeds
Interpre=veGuidance–Pa=entNo=ces! Expectedthatanagency’spa1entswillbeabletoconfirmduringasurveypa1entvisitorotherinterviewthat:
! Theirrightsandresponsibili1es,and
! Thetransferanddischargepoliciesoftheagencywereprovided,
! Inalanguagethatthepa1entunderstood,and
! Inamannerthataccommodatedanydisabilitythepa1entmighthave
Interpre=veGuidance–Pa=entNo=ces! Shouldbeahardcopyunlessthepa1entrequestsanelectronicno1ce
! Ifthepa1ent’sunderstandingofEnglishislimited,theinforma1onmustbeprovidedinalanguageorformatfamiliartothepa1entorhis/herrepresenta1ve
! Useofbilingualstaff,interpreters,formalarrangementswithlocalorganiza1onsthatprovidetransla1onservicesortelephonicinterpreta1onforlanguageassistance
! Agencystaffshouldbetrainedtoiden1fypa1entswithlanguagebarriersandstaffwhohaveongoingcontactwithpa1entsshouldbetrainedineffec1vecommunica1ontechniquesincludingtheuseofaninterpreter
Interpre=veGuidance-Transla=on! Ifthepa1entspeaksalanguagethathasnotbeentranslatedbytheagencyintoitswriFenpa1entrightsmaterials,theagencycandelaytheno1fica1onofpa1entrightsandresponsibili1esun1laninterpreterispresenttotranslate
! ThepermiFeddelayonlyextendstothesecondvisit
! Agencyshoulddocumentthattheverbaldiscussionofrightstookplaceandthatthepa1entorhis/herrepresenta1vewasabletoconfirmunderstandingoftheconversa1on
§484.50(b)-ExerciseofRights! Ifthereislackof“legalcapacity”basedonacourtdecisionorprovisionofstatelaw,
! Rightsofthepa1entmaybeexercisedbythepersonappointedbythecourttoactonthepa1ent’sbehalf
! Intheabsenceofacourtappointedrepresenta1ve,thepa1ent’srepresenta1vemayexercisethepa1ent’srights
! Ifthereisacourtorderastothepa1ent’slegalcapacity,thepa1entmayexercisehis/herrightstotheextentallowedbythecourtorder
Interpre=veGuidance–ExerciseofRights
! Theagencyshouldhavedocumenta1onofanyadjudica1onbyacourtwhichindicatesthatapa1entlackscapacitytomakehealthdecisions
! Thedocumenta1onshouldincludethename(s)ofthosewhohavebeeniden1fiedbythecourttoexercisethepa1ent’srights
! Theagencyshouldhavespecificpoliciesandproceduresinplacetodirecthowdocumenta1onoflegalcapacityisincludedinthepa1entrecord
§454.50(c)–Rightsofthepa=ent1. Tohavehis/herpropertytreatedwithrespect2. Tobefreefromverbal,mental,sexualandphysicalabuseincludinginjuries
ofunknownsource,neglectandmisappropria1onofproperty
3. Tomakecomplaintstotheagencyregardingtreatmentorcare
4. Topar1cipateinandbeinformedaboutandconsentorrefusecareinadvanceoftreatment
5. ToreceiveservicesoutlinedinthePOC6. Tohaveaconfiden1alclinicalrecordandaccesstothatrecord
§484.50(c)–Rightsofthepa=ent7. TobeadvisedoftheextenttowhichpaymentmaybeexpectedfromMedicare,
Medicaidoranyotherfederallyfundedprogram
8. ToreceiveproperwriFenno1ce,inadvanceofachangeordiscon1nua1onofservice
9. Tobeadvisedofthestatetollfreehomehealthhotlineandcontactinforma1on
10. Tobeadvisedofthecontactinforma1onforfederalandstateen11esthatservethepa1ent’sarea
11. Tobefreefromdiscrimina1onorreprisalforexercisinghis/herrighttovoicegrievances
12. Tobeinformedoftherighttoaccessauxiliaryaidsandlanguageservices
Interpre=veGuidance–RespectforPropertyandPerson
! Policyandstafftrainingfocusedonensuringthatpa1entpropertyisrespectedbothinsideandoutsidethehome
! Policyfocusedonagencyconsidera1onofpa1entrequestswithintheparametersoftheassessmentandplanofcare
! Pa1enttreatedasanac1vepar1cipantinthedeliveryofcare! Pa1entisinformedofthevisitscheduleandchangestotheschedule
! Visitsshouldbeonaschedulethatisconvenienttothepa1entandnotnecessarilytheagency’sstaff
Interpre=veGuidance–Abuse,InjuriesandNeglect
! Pa1enthasarighttobefreefromabusefromtheagencystaffandothers! VerbalabuseincludingwriFenorgesturedlanguage! Mentalabuseincludingthreats,humilia1onorthreats! Sexualabuse! Physicalabuseincludingcorporalpunishmentandrestric1veorintrusiveprocedurestocontrolbehavior
! Misappropria1onofproperty–theZfromthepa1entorhis/herhome
! Policiesandproceduresshouldbeinplacetoestablishtheagency’smethodsforensuringrespectforpa1entsandtheirpropertyandhandlingpa1entcomplaintsorotherallega1onsofimproperconduct
InjuriesofUnknownSource! Notwitnessedandpa1entcannotexplaintheinjury! Agencyshouldcarefullydocumentandmonitorthesitua1on
! Allega1onsorevidenceofabusemaywarrantachangeintheplanofcareand/orreferraltoanappropriateagencyforfollowup
! Agencymustinterveneimmediatelyasindicatedbythecircumstancesifaninjuryistheresultofanemployeeac1onandstaffmustberemoved
! Agenciesmustbeabletodemonstrateknowledgeofapplicablestatelaw
Interpre=veGuidance–FilingComplaints! AgencyshouldhavewriFenpoliciesfor:
! Acceptanceofcomplaints! Processingofcomplaints! Reviewprocedures! Resolu1onprocess
! Policiesshouldinclude1meframesforconduc1ngtheinves1ga1on,documenta1onofoutcomesandac1onstobetaken
! Thepa1ent’srecordandhomefoldershouldconfirmthatinforma1onregardingthepa1ent’srighttolodgeacomplaintwasprovided
Interpre=veGuidance–Par=cipa=onandConsent
! Pa1entmustbegivenop1onsregardingcarechoicesandpreferences
! Informedconsentisnotintendedtobethefunc1onofaform
! Informedconsentisongoingascarechangesandevolves
! Allaspectsofcareandservicesandthemannerservicesaretobedeliveredareafunc1onofpar1cipa1onandconsent
! Theremustbeevidenceintherecordthatthepa1entwasconsultedandthathe/sheconsentedtoplannedservicesandcare
! ChangesinthePOCmustbecommunicatedtothepa1entnolaterthanthevisitthatmostcloselyfollowsthechange
! Agencymustdocumentthatthepa1entwasinformedofthechange
MoreonPar=cipa=onandConsent! Extendstocomple1onofassessments
! Disciplinesthatwillfurnishserviceandvisitfrequencies
! Expectedoutcomesofcareincludingpa1ent-iden1fiedtreatmentgoalsandbenefits
! Anyfactorsthatcouldimpacttreatmenteffec1veness
Interpre=veGuidance–ServicesinthePOC! Thepa1entisen1tledtoreceivealloftheservicesandtreatmentsoutlinedinthePlanofCare
! ChangemayberequiredinthewayPOCsaresetforthwithtasksselectedbyassessingclinicians
! MakesurethatthePOCincludesonlythosetasksandtreatments/assessmentsthatarereallyneededbythepa1ent
! IfataskisincludedinthePlanofCare,surveyorsandreviewersaregoingtolookfordocumenta1onthattheservicewasperformed
Interpre=veGuidance–ServicesinthePOC! CMShasclarifiedthatthePlanofCareandamendmentsdonothavetobeprovidedtothepa1entandrepresenta1ve
! But,otherdocumenta1onmustbeprovidedwithin5daysoftheini1alassessment
1.Visitschedulewithfrequencyofvisitsbydiscipline2. Medica1onscheduleandinstruc1ons3. Treatmentsthatwillbeadministered4. Per1nentinstruc1onsrelatedtothepa1ent’scareandtreatments5. Nameandcontactinforma1onoftheagency’sclinicalmanager
Confiden=alityofPa=entRecords! LinktoHIPAAprivacyrequirements
! PrivacyRule–protec1onofhealthinforma1on
! SecurityRule–imposessecurityrequirementsforagenciesandbusinessassociatesregardingconfiden1alityandintegrityofrecords
! BreachNo1fica1onRule–requirescovereden11estono1fyHHSofPHIbreaches
! HIPAArulesalsoprovideforpa1entrightstoobtaincopiesoftheirownrecordsandtorequestcorrec1ons
Pa=entInspec=onofRecords
! Pa1enthastheright,uponverbalorwriFenrequest,toreceivecurrentclinicalrecords
! ThisrequestwouldnecessitateprovisionofthePlanofCareaswellasotherrecords
! Electroniccopiesshouldbeprovidedatnochargeandhardcopiesmustbechargedataratenottoexceedthecommunitystandardforphotocopyingtherecord
! Timeframeforprovidingtheinforma1oniswithinfourbusinessdaysoratthenexthomevisit,whichevercomesfirst
Interpre=veGuidance–PaymentforServicesandChangesinCare
! Pa1ent’srecordmustincludedocumenta1onthatthepa1entwasadvised,priortothestartofservices,oftheextenttowhichservicesareexpectedtobereimbursedbyMedicare
! Documenta1onmustincludeinforma1onastopaymentsthatwouldbeexpectedfromthepa1entifotherreimbursementwerenotavailable
! Ifthepa1ent’scondi1onchangesandneworaddi1onalservicesarerequired,thesameadvanceno1fica1onmustoccurwithrespecttothoseservices
! No1fica1onmustincludeinforma1onaboutthehotlineandexpeditedappealrightsfordiminu1onofservices
Interpre=veGuidance–FederalandStateAssistance
! Pa1entsmustbegivencontactinforma1on–name,addressandtelephonenumber–ofthefollowingagencies:
! AreaAgencyonAging! CenterforIndependentLiving! Protec1onandAdvocacyAgency! AgingandDisabilityResourceCenter! QualityImprovementOrganiza1on
Interpre=veGuidance–FreedomfromReprisal
! Discrimina1onagainstapa1entwhohasfiledacomplaintisprohibited
! Discrimina1onisdefinedastreatmentthatdiffersfromthatprovidedtootherpa1entsfollowingacomplaintwithoutjus1fica1onofthedisparity
! Examplesinclude! Reduc1onofservices! Discon1nua1onofservices! Dischargewithoutmedicaljus1fica1onforthechange
§484.50d)–TransfersandDischarges! Agencymayonlydischargethepa1entunderlimitedcircumstanceswhichmustbedocumentedintheno1cetopa1ents! Necessaryforpa1entwelfare! Reimbursementnolongeravailable! Agencyandphysicianagreethatgoalshavebeenmet! Pa1entrefusesservicesorelectstobetransferred! Dischargeforcausebasedonagencypolicy! Pa1entdeath! Agencyceasestooperate
TransferandDischargeNo=fica=on! Advanceno1ceofthepoten1aldischargeortransfershouldbeprovided
! Pa1entpreferencesatthe1meofdischargeortransfermustbedocumentedandconsidered
! Pa1entshavetherighttorefusethetransferwhichmustbedocumented
! Pa1entsandrepresenta1veshavetherighttoappealthetransferordischargedecision
! Ongoingcommunica1onwiththepa1entandrepresenta1veduringtheprocessiscri1cal
Interpre=veGuidance–Transfer/DCforPa=entWelfare
! Invokedwhenthepa1entrequiresmorethanintermiFentservice
! Transferforspecializedservicesthattheagencycannotprovide! Expecta1onofpoten1aladverseoutcomethatpromptsthetransfer/DC
! Pa1entandphysicianmustbeinformedanddocumenta1onmustbepresentintherecord
! Alterna1veprovidersmustbeiden1fied
! Transfermustbefacilitatedbythehomehealthagencyandpa1entmedicalrecordmustbeprovidedtothereceivingen1typriortoorupontransfer
Transfer/DCforLackofReimbursement! Generallyinvolveslackofongoingmedicalnecessityforservices
! No1cemustbeprovidedatleasttwodaysinadvanceofcompletedischarge
! Somestatesrequiremoreno1cethatcangouptofivedays
! Lackofreimbursementduetoagencyfailuretocomplywithcoverageoreligibilityrequirements
Interpre=veGuidance–Transfer/DCwithGoalsMet
! Intentisthatwhenthepa1entisstabilizedandhealthandsafetygoalshavebeensufficientlymet,serviceswouldnolongerbeneededanddischargeisappropriate
! Ifpa1entdisagreeswiththedischarge,he/sheshouldbeapprisedoftheopportunitytoappealthedecisionaZerreceivingproperwriFenno1ceoftheintenttodischarge
Interpre=veGuidance–Transfer/DCforRefusalofServices
! Pa1entshavealwayshadtherighttorefuseservice
! Declinesofasingletypeofservicearedifferen1atedfromrefusalofservice
! Decliningservicefromapar1culardisciplinemaynotwarrantdischarge
! Refusalsthatwouldhavepoten1aladverseeffectsonthepa1entorcompromisetheagency’sabilitytosafelydelivercarecouldwarrantaDC
! Documenta1onofphysicianno1fica1onofdischargedecisionsshouldbecommiFedtothepa1ent’srecord
! Measuresthattheagencytooktoeducatethepa1entmustalsobedocumented
Interpre=veGuidance–Transfer/DCforCause
! Abusiveordisrup1vebehavior! Threats-bothverbalandnon-verbal! Sexualharassmentorotherincidentsinvolvingthesafetyofstaff
! Otherimpedimentstothesafedeliveryofcare
! Repeateddeclina1onofserviceorpersistentandcounterproduc1vehos1leantudesandbehavior
No=fica=onRequirements–DCforCause! Pa1entandphysicianmusthaveadvanceno1cethattheDCisbeingconsidered
! Othersalsocaringforthepa1entshouldalsobeno1fiedpriortoDC
! Clinicalrecordmustreflect! Problemsencounteredwiththepa1ent! Assessmentofthesitua1on! Communica1onwithmanagementandthephysician! Planforresolvingissues! Resolu1onimplementa1onresults
DCforCause–ImmediateAc=onExcep=on! Whenstaffarethreatenedorendangered
! Canopenthedoorforimmediateac1onwithoutaplantoresolvethesitua1on
! Evidenceshouldbeintherecordthattheagencyprovidedthepa1entand/orrepresenta1vewithinforma1ononalternatecommunityresources
! Pa1entsandrepresenta1vesshouldalsobegivennamesofotheragenciesthatmightbeabletoprovideservice
Interpre=veGuidance–AgencyCessa=onofServices
! Agencyisunabletocon1nueopera1ons! Sufficientno1ceofplannedcessa1onofbusinessisrequired
! Pa1entsmustbegiveninforma1onofotherproviders
! Agencymustfacilitatethesafetransferofpa1entstootheragencies
AgencyIssues–LackofAvailableStaff! NotaddressedintheInterpre1veGuidancebutwascoveredintheFRcomments
! Lackofstaffisnotconsideredanappropriatereasontodischargeortransferapa1ent
! Agencyisresponsibleforassuringavailabilityofstaffwhenthepa1entisadmiFedforcare
AgencyFailures–Acquisi=onoftheF2F! NotaddressedintheInterpre1veGuidancebutwascoveredinthecommentsintheFR
! CoveragerequirementsnotbeingmetduetofailuretocompletetheF2Fshouldbe‘excep1onallyrare’giventhe120day1meframe
! WhentheF2Frequirementisnotmet,theagencycannotholdthepa1entaccountableforpayment
! TheHHAisalsoprecludedfromanabruptdischargethepa1entunlessthereisproperno1fica1onandavaliddischargereason
§484.50(e)–Inves=ga=onofComplaints! Theagencymustinves1gateallcomplaintsmadebypa1ents,theirrepresenta1ves,caregiversandfamily
! Treatmentorcarethatis–orfailstobe–furnished
! Inconsistenttreatment
! Inappropriatetreatment
! Mistreatment,neglectorverbal,mental,sexualorphysicalabuse
! Misappropria1onofproperty
Documenta=onandHandlingofComplaints! Allcomplaintsmustbedocumented
! Includesboththeexistenceofthecomplaintandtheresolu1onthatwasachieved
! Ac1onmustbetakenbytheagencytoavoidfurtherpoten1alviola1onsincludingretalia1onagainstthepersonwholodgedthecomplaint
! AgenciesshouldalsopaycloseaFen1ontostatelawsandrequirementsrelatedtocomplaints
Complaints–AgencyStaffObliga=ons! Whetherdirectlyemployedorprovidingservicesunderarrangement
! Normalcourseofprovidingservicestopa1ents
! Iden1fica1onofincidentsorcircumstancesthatcouldbesugges1veofmistreatment,neglect,abuseorinjury
! Iden1fica1onofmisappropria1onofpa1entproperty
! Allactualeventsorincidentsmustbepromptlyreportedtotheagencyandotherappropriateauthori1es
Interpre=veGuidance-Complaints! Systemsmustbeinplacetorecord,trackandinves1gatecomplaints
! WriFenpoliciesandprocedures! Acceptanceofcomplaints! Processingcomplaints! Complaintreviewandinves1ga1on1meframes! Resolu1onandoutcomes! Communica1on
Interpre=veGuidance-Complaints! Complaintinves1ga1onsshouldbepartoftheQAPIprogram
! Duringasurveytheagencyshouldbeabletoprovidedocumenta1ontoconfirmthatinves1ga1onswereconducted
! Documenta1onshoulddescribeanyac1onstakenbytheagencytoremoveriskstothepa1entduringcomplaintinves1ga1ons
§484.50(f)-Accessibility! Informa1onmustbeprovidedinplainlanguageandinanaccessiblemanner
! Personswithdisabili1esmustbegivenaccesstowebsites
! Auxiliaryaidsandservicesmayberequiredandcannotbeatacosttothepa1ent
! ThosewithlimitedEnglishmustbeabletoaccessinterpre1veservicesandwriFentransla1onsofdocumentsatnocosttothepa1ent
§484.40-ReleaseofOASISInforma=on! AgenciesmusthavewriFencontractswiththirdpar1esthatprocessOASISinforma1on
! Contractsmustobligatethepar1estoensureprotec1onofpa1entiden1fiableinforma1oncontainedinthemedicalrecordincludingOASISdata
! Confiden1alpa1entinforma1onmaynotbereleasedtothepublic
§484.45–Repor=ngofOASISInforma=on! OASISdatamustbeencodedandtransmiFedtotheCMSsystemwithin30daysoftheassessmentcomple1on
! OASISdatamustaccuratelyreflectthepa1ent’scondi1on
! ThetransmiFalformatmustmeetCMSrequirements
! TransmissionsoZwaremustconformtoFIPS140-2standards
! Branchiden1fica1onnumbersmustbeincluded
Interpre=veGuidance-OASIS! Agenciesareresponsibleforthepoliciesoftheirvendorsrelatedtosecurity,confiden1alityofinforma1on,andimpermissibleusesordisclosures
! Agenciesmustensurethattheirworkforcesarecompliantandthattheirvendorsalsohavecomplianceproceduresinplacetoprotecttheconfiden1alityofpersonalhealthinforma1on
! “TheHHAisul1matelyresponsibleforcompliancewiththeseconfiden1alityrequirementsandistheresponsiblepartyiftheagentdoesnotmeettherequirements.”
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