Bass, Berry & Sims attorneys Justin Brown, Dante Lizza and Shannon Wiley, along with Carine Leslie and Valerie Rock with PYA PC, authored an article published by Law360 offering insight on the future of virtual direct supervision and how healthcare providers can prepare.
“Virtual direct supervision – the Medicare payment policy that allows direct supervision through real-time audio-visual technology, rather than in-person presence – has been widely used over the past several years,” the authors said. A product of the COVID-19 public health emergency flexibilities, virtual direct supervision is permitted at least through the end of 2023 following the end of the public health emergency, and it remains to be seen whether the Centers for Medicare & Medicaid Services (CMS) will decide to extend the payment policy or make it permanent.
“If the policy ends, some may find that, overnight, their satellite locations are – or their entire care delivery model is – no longer viable,” the authors wrote. “Worse, this news could come at the end of the year, leaving health care providers and patients to scramble.”
CMS has solicited comments to help its consideration on whether to extend the policy and, if so, what safeguards to adopt. The main issues it appears to be grappling with relate to the quality and safety concerns when care is provided without a practitioner’s physical presence, while many argue that the CMS should rely on the practitioners’ professional judgment to determine whether remote supervision is clinically appropriate in each case – or whether in-person presence is required.
Other considerations relate to the program’s integrity, mostly aimed at remote supervision for services and supplies that are “incident-to” the physician or nonphysician practitioner services, such as prescribed medicines that aren’t usually self-administered.
The authors suggest providers take steps to prepare now, including ensuring they are adequately documenting virtual direct supervision, as well as consider developing written policies and procedures for virtual direct supervision that demonstrate when, where, and why virtual direct supervision is clinically appropriate. They could also review current staffing schedules and capacity to determine needs for additional staff if in-person direct supervision becomes required on a larger scale.
The full article, “Preparing for the Future of Virtual Direct Supervision,” was published by Law360 on July 7 and is available online or in the PDF provided.