Panel decides not to link on-call service to Medicare.(Practice Trends)

WASHINGTON -- On-call services should not be a condition for participating in Medicare, a federal advisory panel on the Emergency Medical Treatment and Labor Act has recommended.

While most panel members panned the idea of an on-call/Medicare link, they were divided over whether to turn their disapproval into a formal recommendation to the Centers for Medicare and Medicaid Services.

Ultimately, the measure to recommend that CMS not link on-call participation with Medicare participation was approved in a close vote (7-6 with one abstention).

The technical advisory group advises the Department of Health and Human Services and the administrator of the Centers for Medicare and Medicaid Services on issues related to the Emergency Medical Treatment and Labor Act (EMTALA).

Hospitals cannot force physicians to be on call, although individual hospital policies may require on-call services as a condition of privileges. To address the shortage of on-call physicians, hospital associations had floated a proposal to the technical advisory group to link on-call participation to Medicare participation or hospital privileges.

Technical advisory group members who voted against making a formal recommendation to CMS at this point said they "were concerned about angering or offending the hospital associations who brought the idea to begin with," said Carol Bayer, M.D., a panel member and vice president for medical affairs at East Jefferson General Hospital in Metairie, La.

If such a link were enacted, however, "physicians would quit Medicare in droves," Dr. Bayer told this newspaper. Participating in Medicare means "you abide by the rules and have to accept the payments, but it has never been linked to anything like this before."