Recent Press Releases


U.S. Sens. John Thune (R-S.D.) and Heidi Heitkamp (D-N.D.) recently introduced the Rural Hospital Regulatory Relief Act of 2017 (S. 243), legislation that would permanently prohibit the Centers for Medicare and Medicaid Services (CMS) from enforcing 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. U.S. Reps. Lynn Jenkins (R-Kan.) and Dave Loebsack (D-Iowa) recently introduced companion legislation in the House of Representatives. 

“CMS’ flawed direct supervision rule is a perfect example of a Washington-based, one-size-fits-all policy that might look good on paper, but does not deliver its desired result,” said Thune. “In this case, like many others, it is rural America that is overlooked. If CMS had its way and this policy was fully implemented, outpatient therapy services in rural South Dakota could be put at risk. It is the wrong approach that could ultimately end up hurting, not helping seniors.”

“Delivering the dependable, accessible health care services rural families need is critical to maintaining strong, thriving communities – but too often, a one-size-fits-all regulations can hinder that access,” said Heitkamp. “By removing barriers that could hurt rural seniors’ abilities to obtain reliable, therapeutic care, we can prioritize the quality services rural towns need to strengthen the health of our statewide community. I’ll keep fighting for smart, commonsense fixes like this bipartisan bill so the nation’s health and regulatory systems fully support the vitality and growth of our rural communities.”

CMS’ 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 Heitkamp 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.   

In response to concerns raised by hospitals and lawmakers, including Thune and Heitkamp, CMS delayed enforcement of its direct supervision policy through 2013 for Critical Access Hospitals and small rural hospitals. Congress suspended enforcement of the regulation from 2014-2016.