[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR412.46]



[Page 479]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 412_PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES

--Table of Contents

 

 Subpart C_Conditions for Payment Under the Prospective Payment Systems 

    for Inpatient Operating Costs and Inpatient Capital-Related Costs

 

Sec. 412.46  Medical review requirements: Physician acknowledgement.



    (a) Basis. Because payment under the prospective payment system is 

based in part on each patient's principal and secondary diagnoses and 

major procedures performed, as evidenced by the physician's entries in 

the patient's medical record, physicians must complete an 

acknowledgement statement to this effect.

    (b) Content of physician acknowledgement statement. When a claim is 

submitted, the hospital must have on file a signed and dated 

acknowledgement from the attending physician that the physician has 

received the following notice:



    Notice to Physicians: Medicare payment to hospitals is based in part 

on each patient's principal and secondary diagnoses and the major 

procedures performed on the patient, as attested to by the patient's 

attending physician by virtue of his or her signature in the medical 

record. Anyone who misrepresents, falsifies, or conceals essential 

information required for payment of Federal funds, may be subject to 

fine, imprisonment, or civil penalty under applicable Federal laws.



    (c) Completion of acknowledgement. The acknowledgement must be 

completed by the physician at the time that the physician is granted 

admitting privileges at the hospital, or before or at the time the 

physician admits his or her first patient. Existing acknowledgements 

signed by physicians already on staff remain in effect as long as the 

physician has admitting privileges at the hospital.



[60 FR 45847, Sept. 1, 1995]