Notice: This CMS-approved document has been submitted - Philips ...

CMS-1403-FC
the patient plan of care must be reviewed by a physician,
nurse practitioner, clinical nurse specialist, or physician
assistant at least every 30 days. The commenters believe
that this conflicts with CMS payment policy, which requires
recertification of the plan of care at least every 90 days.
We also received several unsolicited comments requesting
that we correct this perceived discrepancy.
Response: We did not propose to revise the language
to conform to changes in the timing for recertification of
outpatient therapy plans of care as discussed in the CY
2008 PFS final rule with comment period (72 FR 66396).
Currently, §485.711(b)(3) requires that the plan of care
and results of treatment be reviewed by the physician or by
the individual who established the plan at least as often
as the patient's condition requires, and the indicated
action is taken, which for Medicare patients being treated
in rehabilitation agencies must be at least every 30 days.
We believe that this requirement is in the best interests
of rehabilitation agency patients, and note that by meeting
this condition of participation, facilities would
automatically meet the CMS payment policy requiring review
at least every 90 days.
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