Florida is dealing with the issue from the point of view of medical qualifications. If a physician does not have staffing privileges to perform their ASC procedures in a hospital at a reasonable distance, a transfer agreement must be made in advance. And Georgia notes that hospitals “must not unduly refuse a transfer agreement to the [CSA].” For billing, collection and insurance obligations, the particularities are usually essentially to protect oneself and each for himself. A robust hospital transfer agreement should require each party to maintain professional liability insurance or equivalent insurance, in order to insure its facilities and staff against claims that are made during and after the termination of the agreement. In addition, each party should be responsible for collecting its own fees for the services provided and not be held responsible for the provision of the services provided by the other party. However, current issues focus on the topic of “backward transfer”. In this regard, CMS has indicated in several of my cases that “removal” is an authorized provision in a transfer contract, as long as three criteria are included: the active terms of a hospital transfer agreement vary from case to case and must be recorded in the written document. A transfer contract may have an expiry date or indicate that it remains in effect until a party terminates the contract. An effective emergency transfer depends on the existence of an established procedure, which is why it is strongly recommended to put in place a written agreement between the CSA and its designated local hospital, even if this is not mandatory by state rules or accreditation agencies. Many of the transfer agreements that I have reviewed have not taken these three elements into account. 1. CSOs must not have a written transfer or hospital planning agreement for all physicians.
Centers must provide hospitals with a document containing information about their operation and patient population. Sketched retrocessions may give rise to citations for violation of the conditions of participation in the CMS, but in most cases, EMTALA will probably not apply to a retrocession situation. Each CSA that treats Medicare beneficiaries must be certified by the Medicare program and, therefore, meet federal government requirements for CSAs. One of these requirements requires CSOs to have a written transfer agreement with a local Medicare participating hospital or a non-participating hospital that meets Medicare program requirements for emergency payments.. . . .