I need help finding regulations that govern Medicare billing for contracted dialysis services in an acute care hospital when the hospital doesn't run their own facility. Also, since our hospital doesn't have a license to operate an outpatient dialysis center, we pay the contracted agency to perform outpatient dialysis on patients in our distinct part SNF, but don't bill for it. Can anyone point me in the right direction to find regulations governing this scenario? I read the Medicare handbook, and it doesn't cover these issues in much depth or else I overlooked it somehow.

Also, it would make sense to me if the provider billed Medicare directly, but apparently they're not willing to do that. Is that usual procedure?

Any help you can give me would be much appreciated. I have received a lot of conflicting advice about what's the right thing to do.

We are an acute care hospital and also have a outpatient chronic program, so I can't give you direct info. However, I do know that Baptist Hospital in Pensacola, Fla. contracts out their acute care and NNA of Birmingham, Alabama contracts acute services for almost every hospital in the area except UAB. You might contact some of the financial people there to help with questions.
When we were surveyed a couple of years ago, the hospital had been allowing nurses from the "other" center to come in an dialyze their own patients in our hospital and bill the hospital for the services. The surveyor recommended the practice be stopped or the hospital had to make sure the "contract" nurses met all the qualifications of a regular hospital employee.
Maybe this helps a little.