August 1, 2004

Skilled Nursing Facility Consolidated Billing: Services Furnished Under an Arrangement With an Outside Entity

Whenever a skilled nursing facility resident receives a service from an outside supplier that is subject to the consolidated billing requirements of Medicare Part A, the Social Security Act requires the facility and the supplier to enter into an “arrangement.” CMS recently reminded facilities that these arrangements must be in the form of a written agreement to reimburse the outside entity for Medicare covered services subject to consolidated billing. Despite CMS’ attempt to provide clarification, the “under arrangement” provision remains largely misunderstood. View full article (PDF).