The Science Journal of the American Association for Respiratory Care

1996 OPEN FORUM Abstracts

Getting Paid for Respiratory Care Services Provided Under a Transfer Agreement

W. Douglas Meyer, MBA, RRT Wednesday, November 6, 1996

This presentation will review the requirements for Medicare coverage in the Skilled Nursing Facility (SNF) environment and the criteria for reimbursement for respiratory care services provided to the residents of the SNF by RCP's from an acute care facility (HOSPITAL). Different models of how the relationship is being constructed throughout the country will be discussed with advantages and risks of each presented. More specifically, updates concerning the HCFA guidelines and position concerning RT-SNF relationships will be presented including cost-cutting motivation, cost effectiveness of RT performed in the SNF, and recent directives sent to its Fiscal Intermediaries (FI). An analysis of the factors that influence the FI's determination of whether the RT-SNF relationship is valid will lead to conclusions that will enable the attendees of this presentation to plan a strategy for reasonable assurance that reimbursement will not be denied to SNF's with whom they contract.

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