The American Hospital Association this week urged the Centers for Medicare & Medicaid Services to relax physician supervision requirements for 13 outpatient services, arguing that other nonphysician providers can carry out those services.
The Hospital Outpatient Payment Panel recommended that 28 Healthcare Common Procedure Coding System (HCPCS) services--including administering flu and Hepatitis B vaccines and clipping toenails--did not require direct supervision and suggested they be reduced to general supervision. Although CMS with its preliminary decision in September accepted 15 recommendations as general supervision, it rejected the other 13, Law 360 reported.
"There is little or no research available that evaluates the clinical implications of direct versus general supervision of outpatient services, especially as it relates to specific services covered under the outpatient PPS," AHA Executive Vice President Rick Pollack told CMS Acting Administrator Marilyn Tavenner in a letter Monday.
The hospital association particularly urged general supervision, under the threat of a national physician shortage, especially in rural areas with limited supplies of doctors, AHA wrote.
AHA also said the billing codes don't provide enough distinction in what clinical risks require a higher-level trained professional. The group asked CMS to consider linking particular infusion and injection codes with specific drug codes, as well as creating a list of less complex observation status diagnosis that would warrant general supervision.
For more information:
- see the AHA letter (.pdf)
- here's the Law360 article (subscription required)
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