Regulations at 42 CFR 412.46 require hospitals to obtain one signed acknowledgment from physicians who are being granted admitting privileges at a particular hospital. The physician must complete the acknowledgment at the time that he/she is granted admitting privileges, or before or at the time the physician admits his/her first patient to the hospital. When the hospital submits a claim, it must have on file a signed and dated acknowledgment from the attending physician validating that the physician has received the notice specified in 42 CFR 412.46. Existing acknowledgments signed by physicians already on staff remain in effect as long as the physician has admitting privileges at the hospital.

At least annually, CIMRO of Nebraska will monitor hospitals to ensure that they are appropriately obtaining the acknowledgment statements from physicians with new admitting privileges as required at 42 CFR 412.46. In April of each year, a letter will be sent to all Nebraska PPS hospitals informing them of the requirement and requesting information regarding new physicians who have been granted admitting privileges in the prior year.