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CMS-1403-FC possesses allow him or her to evaluate, treat, and manage patients of all ages with respiratory illnesses. RRTs participate in patient education, implement respiratory care plans, apply patient-driven protocols, follow evidence-based clinical practice guidelines, and participate in health promotion, disease prevention, and disease management. RRTs also may be required to exercise considerable independent judgment. This was implemented in the CY 2002 PFS final rule with comment period (66 FR 55246 and 55311) and the CY 2003 PFS final rule with comment period (67 FR 79966 and 79999) when we developed and discussed G codes, CORF respiratory therapy services, and specifically recognized the RRT as the appropriate level of personnel to provide these CORF services. Finally, the CORF regulations at §485.58(d)(4) state that as a condition of participation for CORFs, CORF personnel must meet the qualifications described at §485.70. For CY 2009, to maintain consistency in the conditions of participation for both CORFs, home health agencies (HHAs), and other outpatient service providers, we proposed to amend the material addressing personnel qualifications in §485.70. Specifically, we proposed to amend paragraphs §485.70(c) and §485.70(e) by referencing the personnel 360

CMS-1403-FC qualifications for HHAs at §484.4. This change would align CORF personnel requirements not only with HHA requirements, but also with other regulations in Part 485 addressing provision of physical therapy, speech-language pathology, and occupational therapy services. Also, at 485.58(a)(1)(i), we proposed to amend the duties of a CORF physician to include medical supervision of nonphysician staff. This change conforms to changes made to the CORF conditions for coverage in the CY 2008 PFS final rule with comment period. We believe that adding medical supervision of nonphysician staff to the duties of CORF physicians more accurately reflects the duties and responsibilities of the CORF physician. We also believe that this change could increase the quality of care provided to patients of CORFs. The following is a summary of the comments received concerning Personnel Qualifications and our responses. Comment: Commenters generally supported our proposed changes. We received a comment that supported the spirit of our proposed changes to the definitions of respiratory therapists and provided further clarification regarding current professional standards. Specifically, in previous comments, the commenter noted that the term “respiratory therapy technician” is an obsolete term. This is because 361

<strong>CMS</strong>-1403-FC<br />

possesses allow him or her to evaluate, treat, and manage<br />

patients of all ages with respiratory illnesses. RRTs<br />

participate in patient education, implement respiratory<br />

care plans, apply patient-driven protocols, follow<br />

evidence-based clinical practice guidelines, and<br />

participate in health promotion, disease prevention, and<br />

disease management. RRTs also may be required to exercise<br />

considerable independent judgment.<br />

<strong>This</strong> was implemented in the CY 2002 PFS final rule<br />

with comment period (66 FR 55246 and 55311) and the CY 2003<br />

PFS final rule with comment period (67 FR 79966 and 79999)<br />

when we developed and discussed G codes, CORF respiratory<br />

therapy services, and specifically recognized the RRT as<br />

the appropriate level of personnel to provide these CORF<br />

services. Finally, the CORF regulations at §485.58(d)(4)<br />

state that as a condition of participation for CORFs, CORF<br />

personnel must meet the qualifications described at<br />

§485.70.<br />

For CY 2009, to maintain consistency in the conditions<br />

of participation for both CORFs, home health agencies<br />

(HHAs), and other outpatient service providers, we proposed<br />

to amend the material addressing personnel qualifications<br />

in §485.70. Specifically, we proposed to amend paragraphs<br />

§485.70(c) and §485.70(e) by referencing the personnel<br />

360

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