A group of 12 health care organizations, including the AHA, today urged the Centers for Medicare & Medicaid Services to withdraw or delay a recent policy change regarding physician supervision of hospital outpatient therapeutic services, and suspend enforcement of the policy until related concerns are addressed. In a letter to CMS, the group said the policy "places a considerable burden on hospitals, requiring them to engage more physicians for direct supervisory coverage without a clear clinical need." Announced in the 2009 outpatient prospective payment system final rule, the policy requires a physician privileged by the hospital to be present in the department whenever outpatient therapeutic services are furnished in the hospital or its outpatient departments, both on and off campus. The group said the full implications of the policy change were unclear until after the final rule was issued and that hospitals were not given adequate time to comply with the policy, which was implemented in January without "effective and adequate" notice.