AHRA Regulatory News Alert: Direct Supervision Changes During the COVID-19 Public Health Emergency

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By Nathan Baugh

 CMS will allow direct supervision to occur through real-time interactive audio and video technology during the public health emergency.

In an interim final rule released on March 30th, CMS explained their rationale for this policy:

In the context of the PHE [Public Health Emergency] for the COVID-19 pandemic, given the risks of exposure, the immediate potential risk to needed medical care, the increased demand for health care professionals in the context of the PHE for the COVID-19 pandemic, and the widespread use of telecommunications technology, we believe that individual practitioners are in the best position to make decisions based on their clinical judgment in particular circumstances. Consequently, we are revising the definition of direct supervision to allow, for the duration of the PHE for the COVID-19 pandemic, direct supervision to be provided using real-time interactive audio and video technology.

CMS also clarifies that this interpretation of direct supervision applies to hospital services:

We note that under current Medicare rules, most therapeutic services in the hospital require only general supervision and the supervision requirements for diagnostic services generally conform to the service-level supervision levels required for payment under the PFS. Because we have every reason to believe that potential exposure risks and limits on the availability of medical professionals could equally apply to hospital services, we are amending the definition of direct supervision for hospital services for the duration of the PHE for the COVID-19 pandemic so it continues to conform with the applicable definitions for services paid under the PFS.

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