New Medicare Conditions of Participation Guidelines for Hospital-based Outpatient Settings
APTA currently is in discussion with the Centers for Medicare and Medicaid Services (CMS) regarding new interpretive guidelines that were issued November 18, 2011. This recent interpretation states that rehabilitation services must be ordered by a qualified practitioner who is responsible for the care of the patient and who has medical staff privileges to write orders for these services. CMS' Conditions of Participation rules apply to both inpatient and outpatient hospital-based settings and apply not only to Medicare beneficiaries but to all patients who receive services at the hospital.
APTA believes that this new interpretation is inconsistent with the current regulation and that it poses problems for physical therapists and their patients in hospital-based settings. The association is working diligently to get further clarification from CMS and will keep members updated as soon as more information is available.