• Fed Regist. 1986 Jun 30; 51 (125): 23541-6.

AbstractThese rules confirm interim final rules published in October 1982, and make the following changes: Provide that a physician who serves without compensation as an officer or director of any home health agency (HHA) is not, for that reason alone, considered to have a significant financial or contractual relationship with the HHA and therefore is not prohibited from certifying the need for home health services and establishing and reviewing a plan of treatment for services to be furnished by that HHA. Remove the provision that a physician who is a partner in an HHA organized as a partnership is, for that reason alone, considered to have a significant ownership interest in the HHA. Under the revised rule, a partner is not prohibited from certifying the need for home health services and establishing and reviewing a plan of treatment for services to be furnished by that HHA, unless he or she has an ownership interest of 5 percent or more. Provide that, effective July 18, 1984, the "significant ownership interest in, or significant financial or contractual relationship with" prohibition does not apply to an HHA that is a sole community HHA, and set forth conditions and procedures for classification as a sole community HHA. Clarify that salaries employment (as well as a contract for services) is a business transaction subject to the $25,000 or 5 percent limitation. Reflect two amendments made by section 952 of the Omnibus Reconciliation Act of 1980 (Pub. L. 96-499). Those amendments provide that a doctor of podiatric medicine (as well as a doctor of medicine or osteopathy) may, if specified conditions are met--Establish a plan of treatment for home health services; and Be considered a physician for fulfilling the requirement that home health services be furnished while the beneficiary is "under the care of a physician". A conforming change was required in section 409.52(b) of the Medicare rule. A conforming change was required in section 409.42(b)(2) of the Medicare rules. Restore provisions that pertain to the timing and signature of certification of need for home health services. Those provisions were contained in previous rules and were unintentionally omitted in the October 1982 revisions. Clarify that--A plan of treatment for speech pathology services may be established only by a physician or by the speech pathologist who will furnish the services to the particular individual; A physician must review a plan established by a speech pathologist; and It is not the intent to require that the plan be established or reviewed by a particular physician. The first and third changes are required to implement recent statutory amendments which provide exemptions from

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