On November 1, 2019, the Centers for Medicare and Medicaid Services (CMS) released the final 2020 rule for the Hospital Outpatient Prospective Payment System (HOPPS), which updates payment policy for services furnished to Medicare beneficiaries in hospital outpatient departments (HOPD).1 Although the policy update is often comprised of incremental refinements, this year’s HOPPS update contains a notable change with potentially widespread effects on cancer care delivery in the US: the final rule lowers the minimum level of supervision for hospital outpatient therapeutic services from “direct supervision” to “general supervision.” Herein we review the impetus behind this change and consider its effect on cancer care in regard to access, safety, and scope of practice.
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Royce TJ, Basch E, Bekelman JE. Supervision Requirements in the 2020 Hospital Outpatient Prospective Payment System: Implications for Cancer Care in the United States. JAMA Oncol. Published online April 09, 2020. doi:10.1001/jamaoncol.2020.0092
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