Certifying To Medical Necessity Under FDA

Law360, New York (April 21, 2011, 12:03 PM EDT) -- Hospital legal counsel and compliance officers are familiar with the legal ramifications of certifying to medical necessity in the context of Medicare, Medicaid and other payor reimbursement rules.

Indeed, recent changes under the federal Patient Protection and Affordable Care Act (PPACA) underscored the importance of thoughtful and informed certifications by physicians ordering many services, including home health and durable medical equipment, now requiring a face-to-face visit with the physician or nurse practitioner prior to the certification.

But a different type of Certificate of Medical Necessity (CMN)...
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