Fed Regist. 1990 Dec 11;55(238):50831-5.
These rules amend the hospice care provisions on physician certification of terminal illness-- To allow up to 8 days to obtain written certification of terminal illness, provided oral certification is obtained within 2 days after the initial period of care begins; and To modify the certification statement which, in its previous form, was shown to discourage physicians from certifying terminal illness and thereby discourage hospice participation in Medicare. These changes are necessary-- To conform HCFA rules to amendments made by section 6005(b) of the Omnibus Budget Reconciliation Act of 1989 (OBRA '89); and To carry out the recommendations of the General Accounting Office (GAO), aimed at encouraging greater participation of hospices in the Medicare program. These rules also simplify and clarify other hospice policies, remove outdated content, and correct cross-references.
这些规定修订了临终关怀护理中关于医生对绝症的认证条款——允许最多8天时间获取绝症的书面认证，前提是在护理初始期开始后的2天内获得口头认证；并修改认证声明，其先前形式显示会阻碍医生对绝症进行认证，从而阻碍临终关怀机构参与医疗保险。这些变更很有必要——使卫生保健财务管理局（HCFA）的规定符合1989年《综合预算协调法案》（OBRA '89）第6005(b)节所做的修订；并落实总审计局（GAO）的建议，旨在鼓励临终关怀机构更多地参与医疗保险计划。这些规定还简化并澄清了其他临终关怀政策，删除了过时内容，并修正了交叉引用。
