(a) Medicare Part A pays for RNHCI home services if the RNHCI provider does the following:
- (1) Submit a notice of intent to CMS to exercise the option of providing home service.
- (2) Provide RNHCI services to eligible beneficiaries,
- (3) Arrange with suppliers to furnish appropriate DME items as required to meet documented eligible beneficiary needs.
- (4) Arrange for RNHCI nurse home visits to eligible beneficiaries.
- (5) Have a utilization committee that assumes the additional responsibility for the oversight and monitoring of the items and RNHCI nursing services provided under the home benefit.
- (6) Meet all applicable requirements set forth in subpart G of this part.
(b) To be an eligible beneficiary to RNHCI home services the beneficiary must:
- (1) Have an effective election in place.
- (2) Be confined to the home, as specified in § 409.42(a) of this chapter.
- (3) Have a condition that makes him or her eligible to receive services covered under Medicare home health.
- (4) Receive home services and DME items from a RNHCI.
- (5) Be responsible for deductible and coinsurance for DME, as specified in § 409.50 of this chapter.
[69 FR 66419, Nov. 15, 2004, as amended at 70 FR 16721, Apr. 1, 2005]