WASHINGTON, DC:Today, legislation introduced by Congresswoman Lynn Jenkins (KS-02), H.R. 4067, was reported favorably out of the House Committee on Energy and Commerce by a 31-11 vote.
“In Eastern Kansas and across America, hospitals in rural communities are being forced to comply with a regulation that makes caring for patients more difficult, while providing no additional benefits,” saidCongresswoman Lynn Jenkins (KS-02). “H.R. 4067 bill will correct this problem by extending the direct supervision requirement moratorium through the end of 2014 and give rural hospitals the certainty they need to continue to provide efficient services to their communities.”
“This bill has already been approved by Unanimous Consent in the Senate,” said Chairman of the Energy and Commerce Committee Fred Upton (MI-06). “It would help ensure that patients – including Medicare patients – across the country, particularly in rural communities, have access to the health care they need.”
Background on H.R. 4067:
As of January 1, 2014, the Centers for Medicare and Medicaid Services (CMS) began enforcing a requirement that physicians must supervise outpatient therapy services at Critical Access Hospitals (CAHs) and other small, rural hospitals. This means that routine outpatient procedures, such as drawing blood or undergoing activity therapy, must now be directly supervised by a physician.
There are over 1,300 CAHs that serve rural Americans in nearly every state, and these facilities simply lack the resources to fulfill this burdensome mandate. Physicians at rural hospitals have not been required to directly supervise these types of outpatient therapy in the past, and asking them to do so now provides no substantial benefits to patients, and at the same time jeopardizes access to care.
What They Are Saying:
The American Hospital Association: While hospitals recognize the need for direct supervision for certain outpatient services that pose high risk or are very complex, CMS’s policy generally applies to even the lowest risk services. Your bill would provide a needed delay in enforcement of the direct supervision policy through 2014 for critical access and small rural hospitals with fewer than 100 beds. Again, we are pleased to support this bill and applaud your commitment to America’s rural hospitals and health care providers.
Anderson County Hospital, Saint Luke’s Health System: In a clarification received from CMS in January, they further instructed us that hospital employed practitioners in hospital-based rural health clinics, even those that are located on the same campus and adjacent to the hospital, cannot meet the direct supervisions requirement for outpatient therapeutic services. This makes it nearly impossible for us to meet the supervision requirements. Although we have a full complement of staff that could provide direct supervision, the ability to use them to provide services is not in question. These requirements present a significant hardship and expense to rural hospitals and is in direct conflict to the Conditions of Participation for CAHs… Because of the implications of these rules and their interpretation on the provision of outpatient therapeutic services at our hospital and many others in rural settings, I ask for your support of H.R. 4067…
National Rural Health Association: The National Rural Health Association applauds your leadership in introducing H.R. 4067. This bill will provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014… We thank you for sponsoring this important legislation. You are truly a stalwart champion for rural America.