Regulations in 42 CFR 413.65 describe the criteria and procedures for determining whether a facility or organization is provider-based. The Medicare Hospital Inpatient Prospective Payment System final rule published on August 1 2002 (67 CFR 50078) revised those regulations that were to become effective on October 1, 2002, for facilities or organizations that were not grandfathered as provider-based and, in the case of grandfathered facilities, effective for main provider cost reporting periods beginning on or after July 1, 2003. Change Request 2411 provides information on the background of the provider-based regulations and notifies fiscal intermediaries of the actions that they are to take to implement the revised regulations.
Listed below are the regulations that have been published in the Federal Register on their respective dates and pages, as well as Change Request 2411.
Also included here is the Highmark Medicare Services recommended attestation form.
This is an example of an acceptable format for an attestation of provider-based compliance. You will need to use the free Adobe Acrobat Reader to read this file.
If you have further questions, please contact:
Eric Huffman at 412-544-1501 or eric.huffman@highmarkmedicareservices.com