Medicare Compliance & Reimbursement

Rural Health:

Follow the Updated Definition of "Privileged" Provider for Ordering Hospital Services

CMS clarifies Transmittal 72 regarding rehab, respiratory care referrals. If you work in a rural health setting, take note: CMS released updated guidelines in 2011 regarding physician orders for hospital rehabilitation and respiratory care services. Now CMS has further clarified Transmittal 72 (https://www.cms.gov/transmittals/downloads/R72SOM.pdf), so make sure your physicians know about the latest change in order to follow it. Background: Transmittal 72 included broad language stating that hospital rehabilitation and respiratory care services must be ordered by a qualified and licensed practitioner who is responsible for the patient's care and who is authorized by the hospital medical staff to order the services. The guideline indicated that the ordering practitioner must have medical staff privileges at the hospital or clinic providing the service. "Many patients are referred for these services by non-hospital staff," CMS representative Kianna Banks said during a March 13 Rural Health Open Door Forum. "We received quite a [...]
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