The AAMC submitted comments to the Centers for Medicare & Medicaid Services (CMS) on June 1 about its first interim final rule [see Washington Highlights, April 3] with comment period to address policy and regulatory provisions in response to the COVID-19 Public Health Emergency (PHE).
Broadly, the AAMC commended CMS for the actions it has taken to support hospitals and physicians during the pandemic. In its comments, the AAMC asked CMS to:
- Support the telehealth waivers and flexibilities included in the interim final rules published April 6 and May 8.
- Support the expansion of the current regulations to allow teaching hospitals to claim direct graduate medical education (DGME) and indirect medical education (IME) for the time a resident performs patient care activities within the scope of their approved program in their own home or in an established patient's home for the duration of the PHE.
- Support the revised rule regarding resident moonlighting during the PHE.
- Support payment for the telephone-only evaluation and management (E/M) codes and recommend this payment be equivalent to payment for E/M services provided as telehealth using video and audio.
- Support the expansion of the telehealth list to include additional services.
- Support the inclusion of both new and established patients for telehealth services and virtual check-in services during the PHE and recommend CMS apply flexibility to enable greater use of interprofessional consultations and other forms of remote care delivery during the PHE.
- Support the option for teaching physicians to provide supervision via real-time, interactive audio/video technology during the PHE.
- Support revisions to rules for residents regarding the Primary Care Exception, teaching physician supervision for the billing of E/Ms, and supervision for the interpretation of diagnostic radiology and other diagnostic tests and psychiatric services during the PHE.
- Support payment during the PHE for routine nursing and related services, use of hospital facilities, and medical social services as inpatient hospital services, even when the hospital provides the services under arrangements outside of the hospital, and ask CMS to make this change permanent.
- Recommend CMS extend the date by which Accountable Care Organizations (ACOs) can terminate participation without loss in the Medicare Shared Savings Program and extend the Next Generation ACO Model for at least one additional performance year to allow ACOs participating in that model the ability to participate in a Medicare ACO program in 2021.
The AAMC also urged CMS to take action to make some waivers and flexibilities permanent and to work with Congress where necessary, such as with telehealth, to ensure patients can continue to benefit from these health care delivery changes after the PHE ends.