Administrative Memos

200005

FROM: Theodore O. Will, Chief Executive Officer
DATE: Apr 18, 2000
SUBJECT: IPRO Protocol For Monitoring The Physician Acknowledgement Statement
IPRO CONTACTS:

Alice Vallar, Senior Director, Health Care Assessment, ext 423

PLEASE NOTE: This memorandum is applicable to Prospective Payment Systems (PPS) Hospitals only

Regulations at 42 CFR 412.46 require hospitals to obtain one (1) signed acknowledgement statement from the physicians who are being granted admitting privileges at a particular hospital. The physician must complete the acknowledgement at the time that he/she is granted admitting privileges at the hospital. When the hospital submits a claim, it must have on file a signed and dated acknowledgement from the attending physician that the physician has received the notice specified in the 42 CFR 412.46 (b). Existing acknowledgements signed by physicians already on staff remain in effect as long as the physician has admitting privileges at the hospital.

The Health Care Financing Administration (HCFA) requires that every Peer Review Organization (PRO) monitor hospitals' processes to assure compliance with HCFA requirements that a signed acknowledgement is maintained on file from each physician treating Medicare patients.

Therefore, in response to this Memorandum, please provide IPRO with the current hospital procedure that is in place to obtain the acknowledgement statement from physicians and how that file is maintained. A copy of the acknowledgement statement that is provided should be included with this information.

Please provide this information by May 31, 2000 to:

Alice Vallar, Senior Director, Health Care Assessment, IPRO, 1979 Marcus Ave., Lake Success, NY 11042

Should you have any questions, please contact Alice Vallar, at extension 423.