1) Please provide a comprehensive overview of how Medicare pays for physician services in teaching settings, detailing the specific criteria that must be met for payment under the Medicare Physician Fee Schedule (PFS) for services furnished by both non-resident physicians and residents, including any exceptions for primary care and the specific requirements for anesthesia services.
2) Elaborate on the guidelines and specific requirements that must be met for medical and surgical services furnished by an intern or resident to be covered as physician services when they are performing “moonlighting” activities, distinguishing between services provided outside the training facility versus those in an outpatient department or emergency room of the training hospital.
3) Explain the core intent behind the establishment of the Accreditation Council for Graduate Medical Education’s (ACGME) Clinical Learning Environment Review (CLER) program as part of its Next Accreditation System (NAS), and describe the anticipated outcomes and benefits of its implementation for graduate medical education (GME) settings.
4) Describe each of the six specific areas of focus for the Clinical Learning Environment Review (CLER) program, outlining what each area encompasses in terms of resident and institutional engagement.
5) Describe the multifaceted responsibilities of the Graduate Medical Education Committee (GMEC) within a sponsoring institution, explaining how it functions as an administrative system to ensure the educational quality of residency programs, including its role in monitoring compliance, reviewing programs, and facilitating continuous quality improvement efforts.
6) Provide a thorough explanation of the proposed performance-based metrics for the future funding of graduate medical education (GME) as presented by Caverzagie, et al., including the foundational categories they identified and their process for metric development.