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Current Issues

Issue Updates


SHM Members Take to Capitol Hill 

On October 19, 2023, SHM members visited Capitol Hill, advocating and educating Congress about important issues in hospital medicine. Our members advocated for Medicare payment reform, solutions aimed at staffing shortages and workforce issues, as well as a fix for the three-day inpatient stay requirement for skilled-nursing facility (SNF) coverage. View Recap

Immediate Elimination of the X-Waiver for Prescribing Buprenorphine

On January 12, 2023, the DEA and SAMHSA announced the immediate elimination of the X-Waiver for prescribing buprenorphine. SHM celebrates this change as a major victory for our collective advocacy efforts and for improving the care of patients with opioid use disorder (OUD). Read More

Policy Update: Split (or Shared) Billing

One-pager on recently finalized rules for split (or shared) billing of hospital visits between physicians and NPs/PAs. Updated November 18, 2022. Read Now


SHM Supports the Improving Access to Medicare Coverage Act

SHM supports the Senate reintroduction of the Improving Access to Medicare Coverage Act. This legislation will count all time spent under observation towards Medicare's three-day stay inpatient requirement for SNF coverage qualification.  Read Letter

SHM Joins Multi-stakeholder Letter Urging Congress to Extend Hospital at Home Waiver

The waiver allowing for the expansion of the Hospital at Home program is set to expire at the end of 2024. SHM joined a multi-stakeholder letter urging Congress to extend the Acute Hospital Care at Home waiver program for at least five years.  Read Letter

SHM Signs AHRQ Appropriations Fund Request

SHM joins 170 other signatories urging the appropriations subcommittee on Labor, Health and Human Services, Education and Related agencies to allocate $500 million in funding for the Agency for Healthcare and Research and Quality (AHQR) Read Letter

Observation Care

Observation is an outpatient designation originally intended to give providers time to decide whether a patient should be admitted to the hospital as an inpatient or discharged back to the community. Policies for observation care and the inpatient admission decision put significant pressure on hospitalists and their patients. Hospitalists are the key players providing observation care in hospitals and see firsthand the challenges and frustrations the policies cause.

Learn more

SHM's Observation White Paper Calls for Elimination of Observation

SHM is calling for major reform to observation care policies to streamline care. Download the white paper to read perspectives from frontline hospitalists and recommendations from SHM that aim to streamline care, reduce administrative burden and protect patients from unpredictable, out-of-pocket costs.

Download white paper

Other Topics

SHM works on an array of other policy issues that impact hospitalists and their patients.

Recent efforts include:

  • Encouraging Congress to support advance care planning by incentivizing patients to create advance directives. Read our letter to Congress.
  • Advocating to the Centers for Medicare and Medicaid Services (CMS) for changes to the evaluation and management (E/M) documentation requirements. Read our letter to CMS.
  • Submitting ideas for relief from administrative and regulatory burdens to the federal administration, including asking for changes to observation, relief from PQRS penalties and addressing issues with MACRA alternative payment models. Read our letters to the House Ways and Means Committee.

Policy Resources

SHM offers hospital medicine professionals a wide variety of resources to navigate the ever-changing policy landscape.

MIPS Guide for Hospitalists

Understanding the Merit-based Incentive Payment System, as part of the Quality Payment Program. What does it mean for you? Learn how to report measures and participate in the Merit-based Incentive Payment System (MIPS).

Download Now

Policy Update on 2022 Medicare Split (or Shared) Billing Rule

Learn more about recently finalized rules for split (or shared) billing of hospital visits between physicians and NPs/PAs. Updated Nov 2022.

Download Now

DEA Licensure Requirement

Learn how to seek or renew DEA registration, which allows providers to prescribe buprenorphine to treat patients with Opioid Use Disorder. Updated April 2023

Learn More