Senator John Thune (R-S.D.) praised last night’s Senate passage of bipartisan legislation sponsored by Senators Thune, Jerry Moran (R-Kan.), and Jon Tester (D-Mont.) that prohibits the Centers for Medicare and Medicaid Services (CMS) from enforcing a regulation that harms access to therapy services in rural areas for calendar year 2014.
The extension of the prohibition on enforcement provides additional time for Thune, Tester, and Moran to advance their Protecting Access to Rural Therapy Services (PARTS) Act (S. 1143), which clarifies that general supervision of outpatient therapeutic services by a physician or non-physician practitioner is sufficient for payment of therapeutic hospital outpatient services.
“Requiring supervising physicians to be present for some outpatient therapy services places an unnecessary strain on the already overextended staff of rural health care facilities,” said Thune. “I applaud my colleagues in the Senate for supporting this legislation that will provide rural health care facilities in states like South Dakota with the flexibility needed to continue to deliver quality outpatient therapy services without being subjected to budget-busting workforce regulations as we seek a long-term solution beyond 2014.”
Outpatient therapeutic services include services such as drug infusions, blood transfusions, and cardiac and pulmonary rehabilitation services. These health care services have always been administered by licensed, skilled medical professionals in hospitals under the overall direction of a physician. However, in its attempt to clarify existing regulations in 2009, the CMS retroactively interpreted existing policy in place since 2001 to require a supervising physician be physically present in the department at all times when Medicare beneficiaries receive outpatient therapy services, the majority of which are low risk.
In response to perennial concerns raised by hospitals and lawmakers, including Senator Thune, CMS delayed enforcement of its direct supervision policy from 2009 through 2013 for Critical Access Hospitals (CAHs) and other small, rural hospitals. Recognizing that CMS would be enforcing the regulation in 2014, Senator Thune offered the PARTS Act as an amendment to the Senate Finance Committee’s SGR and Medicare Beneficiary Access Improvement Act, which passed by voice vote out of committee on December 13, 2013. The language included in the SGR and Medicare Beneficiary Access Improvement Act would permanently prohibit enforcement of this regulation for CAHs. However, until Congress enacts a permanent fix, the legislation passed by the Senate last night would provide for an additional year of non-enforcement of the regulation.The legislation will now be sent to the House of Representatives for consideration.