News Releases

WASHINGTON, D.C. – Last night, the Senate passed S. 1954, bipartisan legislation offered by U.S. Senator Jerry Moran (R-Kan.) to prevent the Centers for Medicare and Medicaid Services (CMS) from enforcing its unreasonable and inflexible direct supervision rules for outpatient therapy services at Critical Access Hospitals (CAH) and other small, rural hospitals in 2014.

"CMS imposing such an unrealistic and clinically unnecessary supervision policy jeopardizes patients’ access to important therapy services in rural communities in Kansas and across the country," Sen. Moran said. "This one-year enforcement delay is needed because many Kansas hospitals are considering cutting services for their patients or limiting hours of operation in order to comply with this inflexible regulation. Congress needs to direct CMS to implement a reasonable policy that more adequately reflects the realities of providing care in rural areas."

In its 2009 outpatient payment rule, CMS mandated a new policy for “direct supervision” of outpatient therapeutic services. Outpatient therapeutic services include services such as drug infusions, blood transfusions, outpatient psychiatric services, wound debridement, and cardiac and pulmonary rehabilitation services. CMS’ policy required that a supervising physician be physically present in the hospital department at all times when Medicare beneficiaries receive outpatient therapy services. Even though it was a significant shift in policy, CMS characterized the change as a “restatement and clarification” of existing policy in place since 2001. In response to concerns of health care providers and policymakers, CMS delayed enforcement of the direct supervision policy through 2013 for CAHs and small and rural hospitals with fewer than 100 beds. However, in its 2014 outpatient payment rule, CMS ended this enforcement moratorium.

S. 1954, cosponsored by Sen. Jon Tester (D-Mont.) and Sen. John Thune (R-S.D.), reinstates this enforcement moratorium for 2014 to ensure CAHs and other rural hospitals in Kansas can continue providing patients with a full range of outpatient therapy services in hospitals in their own communities. Click here to read the full text of the legislation.

In June 2013, Sen. Moran introduced S. 1143, the Protecting Access to Rural Therapy Services (PARTS) Act, to address this therapy supervision issue on a permanent basis. Click here to read a summary of the PARTS Act.