The Frontier Extended Stay Clinic (FESC) demonstration, mandated by Section 434 of the Medicare Modernization Act, allowed remote clinics to treat patients for more extended periods, including overnight stays, than are entailed in routine physician visits.
According to the legislation, a clinic must have been located in a community that is at least 75 miles from the nearest acute care hospital or critical access hospital, or that is inaccessible by public road. The law mandated that the project last for 3 years.
There were 5 clinics participating in the demonstration. All of these clinics received Medicare certification from the CMS Seattle Regional Office. The clinics that participated included:
- Alicia Roberts Medical Center (Prince of Wales Island, Alaska)
- Haines Health Center (Haines, Alaska)
- Cross Road Medical Center (Glennallen, Alaska)
- Iliuliuk Family & Health Services (Unalaska, Alaska)
- Inter Island Medical Center (Friday Harbor, Washington)
The law allowed waiver of provisions of the Medicare program as was necessary to conduct the demonstration project. The FESC addressed the needs of seriously or critically ill or injured patients who, due to adverse weather conditions or other reasons, could not be transferred to acute care hospitals, or patients who needed monitoring and observation for a limited period of time, but did not require hospitalization. The FESC legislation required that the demonstration be budget neutral to the Medicare program.