The Centers for Medicare & Medicaid Services’ Advisory Panel on Hospital Outpatient Payment recently recommended reducing the supervision level for 28 outpatient services from direct to general supervision, meaning the service could be performed under the overall direction of a physician or non-physician practitioner without requiring their presence. The proposed services include certain vaccine immunizations; IV infusion hydration, therapeutic infusions and push injections; various urological services; vascular access services; skin or wound care services; and direct admission to observation services.
CMS’ preliminary decisions on the panel’s recommendations will be posted to the panel’s website soon with a 30-day comment period. Three rural hospitals and health systems – Avera Health, Carrington Health Center and Mission Health System – testified in support of the changes at the panel’s Aug. 28 meeting.
In response to the American Hospital Association and rural hospitals’ concerns with CMS’ direct supervision policy, CMS this year established a process to obtain advice from the panel on the appropriate supervision levels for individual hospital outpatient therapeutic services.