[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

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

[CITE: 42CFR485.719]



[Page 618-619]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 485_CONDITIONS OF PARTICIPATION: SPECIALIZED PROVIDERS--Table 

of Contents

 

   Subpart H_Conditions of Participation for Clinics, Rehabilitation 

Agencies, and Public Health Agencies as Providers of Outpatient Physical 

             Therapy and Speech-Language Pathology Services

 

Sec. 485.719  Condition of participation: Arrangements for physical 

therapy and speech pathology services to be performed by other than 

salaried organization personnel.



    (a) Conditions. If an organization provides outpatient physical 

therapy or speech pathology services under an arrangement with others, 

the services are to be furnished in accordance with the terms of a 

written contract, which provides that the organization retains



[[Page 619]]



of professional and administrative responsibility for, and control and 

supervision of, the services.

    (b) Standard: Contract provisions. The contract--

    (1) Specifies the term of the contract and the manner of termination 

or renewal;

    (2) Requires that personnel who furnish the services meet the 

requirements that are set forth in this subpart for salaried personnel; 

and

    (3) Provides that the contracting outside resource may not bill the 

patient or Medicare for the services. This limitation is based on 

section 1861(w)(1) of the Act, which provides that--

    (i) Only the provider may bill the beneficiary for covered services 

furnished under arrangements; and

    (ii) Receipt of Medicare payment by the provider, on behalf of an 

entitled individual, discharges the liability of the individual or any 

other person to pay for those services.



[56 FR 46562, Sept. 13, 1991. Redesignated and amended at 60 FR 2326, 

2328, Jan. 9, 1995; 60 FR 50447, Sept. 29, 1995]