It appears after much protest, that CMS has REVERSED its requirement to privilege for outpatient rehabiliation:
We therefore believe it is appropriate to interpret §482.54, (the CoP governing outpatient services, which is also silent on the issue of who may order such services), to mean that orders for outpatient services (as well as patient referrals for hospital outpatient services) may be made by any practitioner who is:
• Responsible for the care of the patient;
• Licensed in, or holds a license recognized in the jurisdiction where he/she sees the patient;
• Acting within his/her scope of practice under State law; and
• Authorized by the medical staff to order the applicable outpatient services under a written hospital policy that is approved by the governing body. This includes both practitioners who are on the hospital medical staff and who hold medical staff privileges that include ordering the services, as well as other practitioners who are not on the hospital medical staff, but who satisfy the hospital’s policies for ordering applicable outpatient services and for referring patients for hospital outpatient services.
We are rescinding those portions – and only those portions – of SC-11-28 and SOM Transmittal #72 contained in Tag A-1132, regarding §482.56(b), and in Tag A-1163, regarding §482.57(b)(3), concerning ordering of rehabilitation and respiratory care services, since they are in conflict with the above guidance. The guidance contained in these two tags is rescinded in its entirety and superseded by this memorandum.