In light of the COVID-19 crisis, CMS has announced waivers and flexible policies that specifically address the needs of teaching hospitals. Notably, the CMS guidance document entitled “Teaching Hospitals, Teaching Physicians and Medical Residents: CMS Flexibilities to Fight COVID-19” addresses teaching physician supervision issues and resident FTE time-counting rules that apply during the period of the section 1135 emergency, among many other regulatory waivers.

With respect to teaching physician supervision, CMS is waiving the “physical presence” requirement in many instances, now permitting teaching physicians to provide services with medical residents virtually through audio/visual real-time communications technology. Note, however, that this new rule does not apply universally, and that physical presence is still required in the case of surgical, high-risk, interventional, or other complex procedures, services performed through an endoscope, and anesthesia services.

With respect to counting resident FTE time for DGME and IME payment purposes, CMS is waiving the existing prohibition on counting resident FTE time spent working remotely in a resident’s home or in a patient’s home. CMS specified that a hospital may in fact continue to count a resident’s FTE time toward its DGME and IME FTE counts, so long as the hospital is paying the resident’s stipends and fringe benefits, the resident’s remote work consists of performing duties within the scope of the approved residency training program, and the resident is being properly supervised.

Please do not hesitate to reach out to the GME @ Dentons team during this emergency for any assistance we can provide with respect to your residency programs.