RPA White Paper on Medical Director Responsibilities for Inpatient Hemodialysis and Other Extracorporeal Services

Although there is no regulatory requirement for a hospital inpatient Medical Director for extracorporeal services (unlike that required in the outpatient dialysis setting), physician leadership duties and responsibilities for these services bear striking similarities to those of their outpatient counterparts.  Medical Director obligations in End-Stage Renal Disease facilities are formally described and mandated in the Conditions for Coverage released in 2008, as noted below.  Moreover, the scope of extracorporeal services provided in hospitals has expanded beyond that of routine hemodialysis.  RPA believes that the safe, effective, and quality provision of hospital extracorporeal services are best achieved under the guidance of a nephrologist with expertise and experience in these activities.


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