H.R. 4067, To provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014

H.R. 4067

To provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014

Date
September 9, 2014 (113th Congress, 2nd Session)

Staff Contact
Communications

Floor Situation

On Tuesday, September 9, 2014, the House will consider H.R. 4067, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014, under a suspension of the rules.  H.R. 4067 was introduced on February 18, 2014 by Rep. Lynn Jenkins (R-KS) and referred to the Committee on Energy and Commerce, which ordered the bill reported by a vote of 31-11.[1]

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[1] http://lynnjenkins.house.gov/press-releases/congresswoman-jenkins-bill-to-provide-more-certainty-to-patients-providers-in-rural-communities-passes-favorably-out-of-committee/

Bill Summary

H.R. 4067 directs the Secretary of the Department of Health and Human Services to continue to apply the enforcement instruction on physician supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through the calendar year 2014 (as extended in November 2012 for calendar year 2013 by the Centers for Medicare and Medicaid Services).  This enforcement instruction provides an exception to requirements that certain outpatient therapeutic services in critical access and small rural hospitals be provided under the direct supervision of a physician.

Background

In 2009, the Centers for Medicare and Medicaid Services (CMS) “mandated a new policy for ‘direct supervision’ of outpatient therapeutic services that hospitals and physicians recognized as a burdensome and unnecessary policy change.”[2]  This change required a supervising physician be physically present when Medicare beneficiaries receive outpatient therapeutic services.  After significant pressure from affected stakeholders, CMS delayed enforcement of this policy until January 1, 2014.[3]   However, CMS has been enforcing this policy since the beginning of the year.  H.R. 4067 would delay the enforcement of this policy until the end of the current calendar year.  This legislation is supported by the American Hospital Association and the National Rural Health Association.

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[2] Supervision of Hospital Outpatient Therapeutic Services, American Hospital Association (Apr. 22, 2014), at 1.
[3] See Id.

Cost

CBO estimates that enacting H.R. 4067 would have no significant effect on the federal budget, direct spending, or revenues.[4]

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[4] http://www.cbo.gov/sites/default/files/cbofiles/attachments/hr4067.pdf

Additional Information

For questions or further information contact the GOP Conference at 5-5107.