Recent Press Releases


U.S. Sens. John Thune (R-S.D.), Jerry Moran (R-Kan.), and Jon Tester (D-Mont.) issued the following statements after the U.S. House of Representatives passed their legislation (S. 1461) that would extend through calendar year 2015 a prohibition preventing the Centers for Medicare and Medicaid Services (CMS) from enforcing direct supervision policy for outpatient therapeutic services, a harmful regulation that would jeopardize access to therapy services in rural areas:

 “Getting this important legislation to the president’s desk is a big win for rural states like South Dakota that require greater flexibility in order to maintain their ability to deliver the quality outpatient therapy services that patients deserve,” said Thune. “While it may seem inconsequential to some, extending this prohibition is important as we continue to work toward a more permanent solution that eliminates the barriers that would prevent seniors from having access to therapy services in their communities.”

“Making certain Kansans have access to quality health care remains one of my top priorities in Congress,” said Moran. “Rural hospitals find the federal government’s direct supervision requirements impossible to meet, so I’m pleased this legislation will soon become law to help preserve patients’ access to important therapy services in Kansas and across the country. This measure will also enable us to continue to advocate for passage of the Protecting Access to Rural Therapy Services Act – the PARTS Act – bipartisan legislation I introduced to permanently address this outpatient therapy supervision issue.”

“Folks in rural America shouldn’t have to travel long distances to access quality health care,” said Tester.  “I urge the president to sign this bill quickly so we can begin to reduce red tape and strengthen Critical Access Hospitals so they can continue to provide folks in rural areas with important health care services.”

The Senate passed S. 1461 in September, and it now heads to the president for his signature.  

In response to concerns raised by hospitals and lawmakers, including Sens. Thune, Moran, and Tester, CMS delayed enforcement of its direct supervision policy for Critical Access Hospitals (CAHs) and small rural hospitals through 2013. Congress suspended enforcement of the regulation through 2014.

The regulation is scheduled to go into effect in 2015, but if S. 1461 is signed into law, it will extend the temporary relief to allow the senators additional time to advance their Protecting Access to Rural Therapy Services (PARTS) Act (S. 257), which clarifies that general supervision of most outpatient therapeutic services by a physician or non-physician practitioner is sufficient for payment of therapeutic hospital outpatient services.

The PARTS Act will:

  • Require CMS to allow a default setting of general supervision, rather than direct supervision, for outpatient therapeutic services;
  • Create an advisory panel to establish an exceptions process for risky and complex outpatient services;
  • Create a special rule for CAHs that recognizes their unique size and Medicare conditions of participation; and
  • Hold hospitals and CAHs harmless from civil or criminal action for failing to meet CMS’ current direct supervision policy for the period 2001 through 2016.

Click here to read text of the PARTS Act and here to read text of the 2015 enforcement moratorium bill that is expected to be signed into law.