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COVID-19 and CMS reimbursement for graduate medical education

Apr 03, 2020

Due to the unprecedented circumstances of the novel coronavirus and its associated disease COVID-19, the White House issued an array of temporary Centers for Medicare & Medicaid Services (CMS) rules and regulation changes on March 29, 2020, effective immediately.  In regard to graduate medical education, the following changes are taking place:

Supervision

Under the current guidelines, CMS will pay for services provided by a resident only when a teaching physician is physically present during the key portions of the visit. The new regulations will allow teaching physicians to supervise virtually through telemedicine and real-time communications technology. Of note, CMS emphasizes that this does not, “apply in the case of surgical, high risk, interventional, or other complex procedures, services performed through an endoscope, and anesthesia services.”

FTE count

Under the current guidelines, CMS will reimburse the FTE count for resident time spent in the hospital or certain non-hospital provider settings for DGME and IME purposes. The new regulations allow payment for resident time spent at home or in a patient’s home, as long as they are performing the duties within the scope of the program and have the appropriate supervision requirements met.

Cost reporting

CMS is extending the deadline to cost report due dates as follows:

  • FYE 10/31/19 due 3/31/20 is now due 6/30/20
  • FYE 11/30/19 due 4/30/20 is now due 6/30/20
  • FYE 12/31/19 due 5/31/20 is now due 7/31/20

Should you find that you need assistance or further guidance on this or any other Graduate Medical Education/Health Care matter, please feel free to reach out. Wipfli is always here to help.

Author(s)

Kiki Nocella
Kiki C. Nocella
Director
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Sherine Lazarow
Sherine Lazarow
Senior Manager
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Maggie Fasbender
Maggie Fasbender, UME, GME, CME
Manager
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