Regulations at 42 CFR 412.46 require hospitals paid under PPS to obtain a signed acknowledgement statement from physicians who are granted admitting privileges at a particular hospital.
A physician must complete the acknowledgement statement at the time that he/she is granted admitting privileges at the hospital before, or at the time, the physician admits his/her first patient to the hospital.
As the Quality Improvement Organization for Tennessee, Qsource is authorized by the Medicare program to ensure, on an ongoing basis, that hospitals are appropriately obtaining acknowledgement statements (penalty statements) from physicians with new admitting privileges as required in 42 CFR 412.46.
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Download the common errors/deficiencies found during monitoring fact sheet.
Some errors/deficiencies listed are for information only, while others are reportable to the FI/MAC and/or CMS.




