Adult supervision encouraged.

Top Line: Who’s covering the clinic tomorrow morning? 
The Final Rule: Most of us are familiar with the intricacies of Medicare supervision requirements specifying radiation as a therapeutic service that requires “direct” supervision in both hospital-outpatient departments and free-standing centers. Direct supervision basically means that a provider is “immediately available” to direct the service but doesn’t have to physically be present in the room. Now, CMS has released a final rule for 2020 that relaxes all supervision requirements to “general.” General supervision means that the plan of care is directed and overseen by the treating physician, with no specific requirements on his/her presence during treatment. The rationales are 1) a two-tiered system already exists where rural and critical-access hospitals have general supervision requirements and other hospitals have direct supervision requirements, and 2) the quality of therapeutic services at the former doesn’t appear to have been adversely affected by the relaxed requirements. Despite commentators suggesting that highly complex things like radiation therapy might deserve more than general supervision, CMS decided to keep things simple and apply one rule across the board. Instead, they put their faith in the discretion of hospitals and providers to continue requiring higher standards of supervision when called for. While most will likely do just that, there may be some with the opinion that radiation therapy can easily be supervised while sailing the Caribbean. 
TBL: Based on the CMS HOPPS final rule for 2020, radiation therapy can be delivered in all hospital-outpatient (as opposed to free-standing) clinics under more lenient “general” supervision. | CMS 2019

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  20. I want to use this opportunity to thank Dr Oyagu for the grate work he has done for me and my cousin sister, I was cured from herpes virus through his herbal remedy and my cousin sisters was also cured from Cancer. This is a grate testimony for what Dr Oyagu Has done for me and my entire generation. I’m giving this testimony so that those of you out there can contact him while he keeps saving my relatives. Send him a Dm and get a better health totally. Contact him via WhatsApp +2348101755322 or Email address:oyaguherbalhome@gmail.com you can also reach him on his website https://oyaguspellcaster.wixsite.com/oyaguherbalhome

    ReplyDelete
  21. Powerful Herbal treatment is 100% guaranteed to cure Herpes Virus, The  main reason why most people are finding it difficult to get cured from HSV 1& 2  is because they believe on medical treatment, i want you to know that drugs and medical treatments is not helpful to cure HSV permanently but it can only help you control it but the truth is in life time it will still be inside your nervous system, But Natural roots/herbs are the best remedy which can easily eradicate herpes forever. I never believed it until I was helped and cured of my 2 months genital herpes with natural herbal medicines from Dr. OKITI . Where other medical prescribed drugs and treatments failed, Dr. OKITI herbal medication helped me and cured me from herpes virus permanently and I’m so grateful for this. You can also get help from this great and powerful African Herbalist called Dr. OKITI by reaching him via email: Drokitiherbalhome100@gmail.com or call/whatsapp him at +234 705 067 0365. Thank you so much Dr. OKITI.

    ReplyDelete
  22. HERPES CURE....THIS IS REAL ! TAKE TIME TO READ TESTIMONY OF HOW I GOT CURED FROM GENITAL HERPES SIMPLEX VIRUS WITHIN 14 DAYS [with Herbal Traditional medicine] website  https://drharryherbaltempl.wixsite.com/solutiontemple   WHATSAPP +2349036417079 email drharrysolution@gmail.com  
    Hello Everyone out there, I'm Toshia Cook, from Texas USA. I am here to give my testimony about a Herbalist called Dr  HARRY, who helped me in my life. I was infected with HERPES SIMPLEX VIRUS 2 in 2016, i went to many hospitals for cure but there was no solution, so I was thinking how can I get a solution out so that my body can be okay. One day I was at the train station park  side thinking where I could get  a Solution. so a my old friend walked to me asking me why I was so sad and i opened up all to her telling her my problem, she told me that she could help me out, she introduced me to a doctor who uses herbal medication to cure HERPES SIMPLEX VIRUS 2 and gave me his email, drharrysolution@gmail.com so i mailed him. He told me all the things I needed to do and also gave me instructions, which I followed properly. Before I knew what is Happening after two weeks of using his powerful meds the HERPES SIMPLEX VIRUS that was in my body was cured and i tested negative when i conducted a test .i am so happy today because of Dr Harry  . so if you are also heart broken and also need a help, you can also reach him on his website  https://drharryherbaltempl.wixsite.com/solutiontemple   WHATSAPP +2349036417079 email drharrysolution@gmail.com  He also have a herbal cure for PENIS ENLARGEMENT ,PREMATURE EJACULATION,LOW SPERM COUNT ,ERECTILE DYSFUNCTION,HIV, CANCER, ASTHMA, IMPOTENCE, BARENESS/INFERTILITY ... CURE YOUR  SELF FROM THAT ILLNESS TODAY,DON'T SPREAD YOUR INFECTION OR DISEASES TO OTHER PEOPLE. Contact him today and you will have a testimony...Good luck      

    ReplyDelete
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  26. I Want To Appreciate Dr OYAGU for his great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And i Was Looking For Solution To Be Cured Luckily I Saw Testimonies On How Dr OYAGU Cure Herpes Virus I Decided To Contact Dr OYAGU I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have The Same Herpes Virus Please contact Dr OYAGU To Help You Too,And Help Me To Thank Dr OYAGU For Cure Me, I’m Cured By Dr. OYAGU Herbal Medicine,His Contact Email:oyaguherbalhome@gmail.com or viste his website https://oyaguspellcaster.wixsite.com/oyaguherbalhome
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    ReplyDelete
  27. Never give up in life they all say no cure to Herpes Virus which is a big lie I have pass through many process also i never believe there is really cure to HERPES until I meet Dr. Kham the doctor that have been helping many people for many years, I come across this doctor online when I was searching for cure online I found out about this man, and to my greatest surprise this man have the herbal medicine which I have been looking for years I explain my problem to him through the email I found on someone who testify about him also, Dr. Kham write me a reply and explain how the process work so after ordering for the medicine I got it within 4 days and I took it according to the way Dr. Kham instructed, I was so happy after two week I took the medicine there was very big change in my health when I was done with the process I go for test, I found out I am negative that was the day I have the tears of joy you can also get in contact with my doctor through his email now dr.khamcaregiver@gmail.com or you can also WhatsApp him +2348159922297, You can Also Visit his website to know more about him at > https://drkhamherbalhealingcenter.wordpress.com/ or https://drkhamcaregiver.wixsite.com/drkhamcaregiverherba He also have herbs medicine to cured the following diseases; eczema,urethra wart,chronic problems.Herpes, Cancer, Als,Hepatitis, Diabetes, HPV, HIV, Diabetes, Fibroid, Infections,ulcer ETC

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  30. Hello everyone, sharing this testimony is my greatest happiness also to let every patient know there is cure to get rid of  human papillomavirus. I was once a HPV patient  for a very long time. I have been taking medications because my doc in Canada told me there is no cure except pills to control it which i have been taking. Until I found a faithful and truthful herbalist who finally cured me with herbal  remedy. Everything about the virus was gone, my genital warts I have been trying to remove, they all cleared off. Here is the herbalist information to reach him via : Dronokunherbalcure@gmail.com or his website  https://Dronokunherbalcure.wordpress.com or facebook page @naturaltreatmentcenter1 Dr Onokun is great and very kind to every patient.

    ReplyDelete
  31. Hello Everyone out there,I am here to give my testimony about a Herbalist doctor who helped me . I was infected with HERPES SIMPLEX VIRUS in 2011, i went to many hospitals for cure but there was no solution, so I was thinking how can I get a solution out so that my body can be okay. One day I was in the river side thinking where I can go to get solution. so a lady walked to me telling me why am I so sad and i open up all to her telling her my problem, she told me that she can help me out, she introduce me to a doctor who uses herbal medication to cure HERPES SIMPLEX VIRUS and gave me his email, so i mail him. He told me all the things I need to do and also give me instructions to take, which I followed properly. Before I knew what is happening after two weeks the HERPES SIMPLEX VIRUS that was in my body got vanished . so if you are also heart broken and also need a help, you can also email him at {oliha.miraclemedicine@gmail.com}
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    ReplyDelete
  32. I want to testify about Dark Web blank atm cards which can withdraw money from any atm machines around the world. I was very poor before and have no job. I saw so many testimony about how Dark Web hackers send them the atm blank card and use it to collect money in any atm machine and become rich. (: blankatmhackmechine@gmail.com     ) I email them also and they sent me the blank atm card. I have use it to get 90,000 dollars. withdraw the maximum of 5,000 USD daily. Dark Web is giving out the card just to help the poor. Hack and take money directly from any atm machine vault with the use of atm programmed card which runs in automatic mode.

    ReplyDelete
  33. I want to testify about Dark Web blank atm cards which can withdraw money from any atm machines around the world. I was very poor before and have no job. I saw so many testimony about how Dark Web hackers send them the atm blank card and use it to collect money in any atm machine and become rich. (: blankatmhackmechine@gmail.com     ) I email them also and they sent me the blank atm card. I have use it to get 90,000 dollars. withdraw the maximum of 5,000 USD daily. Dark Web is giving out the card just to help the poor. Hack and take money directly from any atm machine vault with the use of atm programmed card which runs in automatic mode.

    ReplyDelete
  34. BITCOIN, BINARY OPTION: Please everyone should be careful and stop being fooled by all these brokers and account managers, they scammed me over $200,000 of my investment capital, they kept on requesting for extra funds before a withdrawal request can be accepted and processed, in the end, I lost all my money. All efforts to reach out to their customer support desk had declined, I found it very hard to move on. God so kind I followed a broadcast that teaches on how scammed victims can recover their fund, I contacted the email provided for consultation, I got feedback after some hours and I was asked to provide all legal details concerning my investment, I did exactly what they instructed me to do without delay, to my greatest surprise I was able to recover my money back including my profit which my capital generated. I said I will not hold this to myself but share it to the public so that all scammed victims can get their funds back, :::::::  if you have problems on any stuffed like a bank, company, examinations, database, Social media hacks, Email hacks, Phone hacks, Bitcoin hacks, increased Credit score boost to 800, School result upgrading, Binary option funds recovery Instagram, Bitcoin Mining, WhatsApp, Twitter,  Monitor your colleague, access your spouse social media, and a lot more: Email.  ( contact@wizardcharlesgrouphackers.com ).

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  35. BITCOIN, BINARY OPTION: Please everyone should be careful and stop being fooled by all these brokers and account managers, they scammed me over $200,000 of my investment capital, they kept on requesting for extra funds before a withdrawal request can be accepted and processed, in the end, I lost all my money. All efforts to reach out to their customer support desk had declined, I found it very hard to move on. God so kind I followed a broadcast that teaches on how scammed victims can recover their fund, I contacted the email provided for consultation, I got feedback after some hours and I was asked to provide all legal details concerning my investment, I did exactly what they instructed me to do without delay, to my greatest surprise I was able to recover my money back including my profit which my capital generated. I said I will not hold this to myself but share it to the public so that all scammed victims can get their funds back, :::::::  if you have problems on any stuffed like a bank, company, examinations, database, Social media hacks, Email hacks, Phone hacks, Bitcoin hacks, increased Credit score boost to 800, School result upgrading, Binary option funds recovery Instagram, Bitcoin Mining, WhatsApp, Twitter,  Monitor your colleague, access your spouse social media, and a lot more: Email.  ( contact@wizardcharlesgrouphackers. com ).

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  36. I cured my Genital herpes and Warts with Herbal Medicine, I will tell you it is safe and reliable, I came across a testimony on youtube of Herpes Breakthrough which I contacted the doctors email on the testimony. Dr Oduduwa replied me and after much discussion sent the herbal medicine to my door step which I took for three weeks and my warts were cured with my Herpes virus contact him and get your cure. His herbal medicine is globally approved. for more about Dr Oduduwa visit him on; https://dr-oduduwaherbalcenter.jimdofree.com, https://oduduwaherbalcenter.over-blog.com/ or contact him on Whatsapp/Telephone +234-8169961036.... THANKS TO ALMIGHTY GOD THE SAVER OF LIFE.

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  37. Thanks so much Wizard Charles Group Hackers, i really don't know what to say here and i don't know if you will ever find out my post here so you could confirm how grateful i'm over the job i contacted you of which i nearly lost all my bitcoin to a bad black hat hacker who just came from nowhere to messed up my life all because i needed his help to help me access my spouse device so i can see the lady he is talking to online but instead he choose to work against me not only ripping me but went ahead to black mail me just to get another more money from my spouse but he failed and that couldn't have happened if not for Wizard Charles Group Hackers intervention, i owe my life cause i'm still breathing today is all because of his intervention, he tracked down the hacker who worked against me and also help me to recover all my lost funds and still do the same job i needed of which is to gain access to my spouse phone and see who he is talking to and what they are both talking about cause he always denied me access to his phone. Indeed I'm grateful to Wizard Charles Group Hackers. Email: ( info@wizardcharlesgrouphackers.com  )
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  39. just to make the story short, few weeks ago i found a herbalist Dr. online who has cured thousand of HPV virus patients with 100% excellent result and i inquire the treatment for me and my husband taking it for two weeks and we got cured i just want to use this medium to thanks Dr Ogedegbe for his wonderful treatment he so-much saved us from this virus his information has been attached to my post you can reach out to him via:  dr.ogedegbe6@gmail.com, whatsapp number +2348109374702  . Thanks to you Dr Ogedegbe for curing me and my husband from this deadly virus.He also cured the following ......HERPES.....HIV....ALS...COPD...CANCER......DIABETES.......

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  42. A big thanks to this medium for the opportunity given for self-expression, I'm Carolyn Den Har from the United State. I was having a problem with my crypto account and decided to look for a hacker who will help me to access it and reset my password cause I needed some funds and crypto has been my bank account cause that's where all my savings goes to, I found one hacker who seems to be real but at the end of it all he hacked my bitcoin and disappear then the world becomes hell to me so I had to contact Cyber Solution who made it possible again for me to recover my funds. all thanks to cybersolution@technologist.com.  

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  43. How amazing it is to have all lost hope back with the right person whereby life has been so difficult after encountering a heartbreak with a broker who made away with my $39k and shorts down there site probably because they did the same to others, have tried two hackers but nothing happened until I hired wizard Harry who was able to help me recover my funds back and I really don't know how he did it but honestly, I receive exactly $39k worth of bitcoin on my wallet and for this reason, I'm referring everyone under the same circumstance to quickly contact wizardharry@programmer.net for a fast solution with a guarantee. he will give you all proof needed.

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  44. I was so anxiuos to know what my husband was always doing late outside the house so i started contacting investigators and was scamed severly until i almost gave up then i contacted this one private investigator and he delivered a good job showing evidences i needed from the apps on his phone like whatsapp,facebook,instagram and others and i went ahead to file my divorce papers with the evidences i got,He also went ahead to get me back some of my lost money i sent to those other fake investigators,every dollar i spent on these jobs was worth it.Contact him so he also help you.
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  45. I lost my bitcoin to fake blockchain.com impostors on Facebook, they contacted me as blockchain official support and i fell stupidly for their mischievous act, this made them gain access into my blockchain wallet account,whereby 7.0938 btc was stolen from my wallet in total. I was almost in a comma and dumbfounded because this was all my savings i banked up on, waiting for bitcoin rate to improve. Then my niece recommended me to an expert, I researched online and found the recovery expert , with the contact address- Liamsophia39@gmail.com or whatsapp +1 (814)503-0528.I wrote directly to the specialist explaining my loss. Hence, she helped me recover my bitcoin just after 1 week she helped me launch the recovery program, and the culprits were identified as well, all thanks to his expertise. I hope I have been able to help someone as well. Reach out to the recovery specialist to recover you lost funds from any form of online scam

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