Wiki Subcontracted staff

vostrum1206

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Does anyone know what the requirements are for a subcontracted employee? For example if a physician subcontracts a nurse to perform allergy services in his office under direct supervision, is the physician able to bill for these services?
 
Heres some information I found:

https://www.law.cornell.edu/cfr/text/42/410.26

42 CFR 410.26 - Services and supplies incident to a physician's professional services: Conditions.


(1)Auxiliary personnel means any individual who is acting under the supervision of a physician (or other practitioner), regardless of whether the individual is an employee, leased employee, or independent contractor of the physician (or other practitioner) or of the same entity that employs or contracts with the physician (or other practitioner), has not been excluded from the Medicare, Medicaid and all other federally funded health care programs by the Office of Inspector General or had his or her Medicare enrollment revoked, and meets any applicable requirements to provide incident to services, including licensure, imposed by the State in which the services are being furnished.

(2)Direct supervision means the level of supervision by the physician (or other practitioner) of auxiliary personnel as defined in § 410.32(b)(3)(ii).


(3) General supervision means the service is furnished under the physician's (or other practitioner's) overall direction and control, but the physician's (or other practitioner's) presence is not required during the performance of the service.


(4)Independent contractor means an individual (or an entity that has hired such an individual) who performs part-time or full-time work for which the individual (or the entity that has hired such an individual) receives an IRS-1099 form.


(5)Leased employment means an employment relationship that is recognized by applicable State law and that is established by two employers by a contract such that one employer hires the services of an employee of the other employer.


(6)Noninstitutional setting means all settings other than a hospital or skilled nursing facility.


(7)Practitioner means a non-physician practitioner who is authorized by the Act to receive payment for services incident to his or her own services.


(8)Services and supplies means any services or supplies (including drugs or biologicals that are not usually self-administered) that are included in section 1861(s)(2)(A) of the Act and are not specifically listed in the Act as a separate benefit included in the Medicare program.

Though it looks like it may differ based on state:

Texas for example mentions leased employees but not contractors

https://www.texmed.org/Template.aspx?id=2274
 
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