Senator John Thune (R-South Dakota) today praised the House of Representatives’ passage of bipartisan legislation (H.R. 4067) originally authored by Thune, and Senators Jerry Moran (R-Kansas), and Jon Tester (D-Montana), which extends a prohibition on 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. Next, the Senate, which previously passed Thune’s companion legislation (S.1954) in February of 2014 by unanimous consent, will likely consider the House-passed version before sending the bill to the president to be signed into law.
The extension provides additional time for Thune, Tester, and Moran to advance their Protecting Access to Rural Therapy Services (PARTS) Act (S. 1143), which would permanently clarify that general supervision of outpatient therapeutic services by a physician or non-physician practitioner is sufficient for payment of therapeutic hospital outpatient services.
“Rural health care providers across South Dakota understand that this regulation crafted by Washington bureaucrats would place an unnecessary strain on the already overextended staff of our health care facilities,” said Thune. “I’m pleased that my bipartisan legislation to extend the prohibition of this burdensome regulation and provide rural health care facilities with the flexibility needed to continue delivering quality outpatient therapy services may soon become law. I will continue to press my colleagues in Congress to pass my long-term solution to ensure our rural providers are not faced with this unnecessary regulation 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 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, 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 SGR fix, the legislation would provide for an additional year of non-enforcement of the regulation.
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