The Centers for Medicare & Medicaid Services has instructed Medicare contractors not to evaluate or enforce the "direct supervision" requirement for therapeutic services furnished in calendar year 2010 to outpatients in critical access hospitals.
According to the American Hospital Association, the agency said in a notice to Congressional committees on Monday that "CMS believed this requirement to be a clarification of longstanding policy, but the rule has generated concern among some rural providers who had previously interpreted the CMS policy to require only 'general supervision' and who believe that it may be difficult to meet this requirement."
CMS intends to revisit the issue through the annual rulemaking cycle for CY 2011.
The final 2010 hospital outpatient prospective payment system rule included a "direct supervision" policy that requires a supervisory physician or non-physician practitioner to be present on a hospital or CAH campus when outpatient therapeutic services are performed, and that they be immediately available to provide assistance and direction throughout the duration of procedures.
Lawrence Hughes, the AHA's assistant general counsel, said the hospital association would "continue to advocate for additional changes to the policy, as the CMS announcement does not address all of the problems that hospitals have identified."