Recent Press Releases


U.S. Sens. John Thune (R-S.D.) and Debbie Stabenow (D-Mich.) today reintroduced the Rural Hospital Regulatory Relief Act (S. 895), legislation that would permanently prohibit the Centers for Medicare and Medicaid Services (CMS) from enforcing its direct supervision policy for certain outpatient therapeutic services, a harmful regulation that would jeopardize access to therapy services, particularly in rural areas where there are fewer practicing physicians.

“CMS’s willingness to acknowledge the challenge this policy poses for rural providers through recent regulation and guidance is appreciated,” said Thune. “However, it is not a matter of hospitals needing more time to come into compliance. The workforce challenges in rural America are real, and this is one common-sense fix we can make to ensure access to quality services is not disrupted.”

“People across Michigan rely on rural hospitals to get the care they need,” said Stabenow. “Our legislation removes an unnecessary burden on rural hospitals and makes it easier for patients in small towns and rural communities to continue to get treatment at facilities in their communities.”  

“The Rural Hospital Regulatory Relief Act of 2019 would provide immediate and permanent regulatory relief to small, rural hospitals and ensure these communities will continue to have access to outpatient therapeutic services,” said American Hospital Association Executive Vice President Tom Nickels. “America’s hospitals and health systems are pleased to support this legislation and applaud Senators Thune and Stabenow for their continued leadership on behalf of rural hospitals and the patients and communities they serve.”

“Workforce in our rural community hospitals is a challenge every day … Each time the federal government adds more rules and regulations, the more difficult it is for the rural hospitals to stay in business,” said South Dakota Health Care Association President Tim Rave. “The more rules and regulations, the more staff time is spent on compliance rather than direct quality care to patients.”

CMS’s policy would require practicing physicians to directly supervise other certified medical professionals who deliver outpatient therapy services. Without direct supervision, this type of service could not be administered. Thune and Stabenow believe there is a more efficient and cost-effective approach, which would allow other certified medical professionals, like general practitioners, to provide outpatient therapy services with a more indirect role from a physician.  

Following the enactment of multiple one-year legislative fixes, and at Thune’s urging, CMS’s 2018 Hospital Outpatient Prospective Payment System final rule reinstated non-enforcement for 2018 and 2019.