CMS SOM App. W, Tag C-0999

The

CAH requires that—

(1) The quality and appropriateness of the diagnosis and treatment furnished by nurse

practitioners, clinical nurse specialist, and physician assistants at the CAH are evaluated

by a member of the CAH staff who is a doctor of medicine or osteopathy or by another

doctor of medicine or osteopathy under contract with the CAH.

(2) The quality and appropriateness of the diagnosis and treatment furnished by doctors

of medicine or osteopathy at the CAH are evaluated by—

(i) One hospital that is a member of the network, when applicable;

(ii) One Quality Improvement Organization (QIO) or equivalent entity;

(iii) One other appropriate and qualified entity identified in the State rural health

care plan;

(iv) In the case of distant-site physicians and practitioners providing telemedicine

services to the CAH’s patient under an agreement between the CAH and a

distant-site hospital, the distant-site hospital; or

(v) In the case of distant-site physicians and practitioners providing telemedicine

services to the CAH’s patients under a written agreement between the CAH and a

distant-site telemedicine entity, one of the entities listed in paragraphs (d)(2)(i)

through (iii) of this section.

(3) The CAH staff consider the findings of the evaluation and make the necessary

changes as specified in paragraphs (b) through (d) of this section.

Interpretive Guidelines §485.631(d)(1),(2)(i)(ii)(iii)(iv)(v),(3)

Guidance is pending and will be updated in future release.

Survey Procedures §485.631(d)(1),(2)(i)(ii)(iii)(iv)(v),(3)

Survey Procedures are pending and will be updated in future release.