Medicare Managed Care Manual (Pub. 100-16), Ch. 17f § 120.2
Certification
120.2 - Certification
(Rev. 77, Issued: 10-28-05, Effective Date: 10-28-05)
The Medicare cost plan must furnish the required services to its Medicare enrollees
through providers and suppliers that meet applicable Medicare statutory definitions and
implementing regulations.
•
Hospitals, SNFs, HHAs, CORFs, and providers of outpatient physical therapy or
speech-language pathology services must meet the applicable conditions of
participation in Medicare;
•
Suppliers must meet the conditions for coverage or conditions for certification of
their services;
•
If more than one type of practitioner is qualified to furnish a particular service, the
Medicare cost plan may select the type of practitioner to be used.