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Physician Regulatory Issues Team (PRIT)

Past PRIT Issues


  Details for Hospital Privileges for Physicians Working with Medicare Managed Care
  

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Issue Name Hospital Privileges for Physicians Working with Medicare Managed Care
Issue Physicians feel burdened by the CMS requirement that all physicians in a Medicare Managed Care Plan network have hospital privileges
Status See below.
Date Issue Created 01/01/2002

CMS has clarified that not all physicians in a M+C network are required to have hospital admitting privileges so long as the plan has an adequate panel of physicians with such privileges, and, CMS has extended from two years to three years, the time period for plans to re-credential physicians, consistent with the national accrediting community.

CMS also allows physicians to attest to their malpractice coverage and hospital admitting privileges, instead of having to submit source documents. 


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Last Modified Date : 05/10/2006
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