Health Law Checkup - July 13, 2009
CMS "Restatement and Clarification" of Physician Supervision Policy Requires that Physicians Must Be Present in On- or Off-Campus Provided-Based Departments


In its 2009 Calendar Year Outpatient Prospective Payment System Final Rule, the Centers for Medicare and Medicaid Services stated that in order to qualify for Medicare reimbursement outpatient therapeutic services must be provided under the direct supervision of physicians in the hospital and in all provider-based departments of the hospital (on and off campus). This contrasts to statements by CMS in its 2000 Calendar Year Outpatient Prospective Payment System Rule that it assumed "the direct supervision requirement is met on hospital premises because staff physicians would always be nearby within the hospital." CMS cited quality care issues as the reasoning for this recent "restatement and clarification" of the 2000 Rule.

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