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From Health Law Daily, December 10, 2015

House extends moratorium on CMS enforcement of direct supervision requirement

By Mary Damitio, J.D.

The House of Representatives passed a bipartisan bill to extend a moratorium that would prevent CMS from enforcing its direct supervision policy for outpatient therapeutic services provided in critical access and small rural hospitals. The bill (S. 1461), which previously cleared the Senate in September, extends the moratorium through 2015, and provides lawmakers with additional time to pass the Protecting Access to Rural Therapy Services (PARTS) Act of 2015 (S. 257, H.R. 1611), which would adopt default general supervision standards for outpatient therapeutic services.

Direct supervision. In 2009, CMS set forth its policy that required direct supervision of outpatient therapeutic services. Under the policy, a physician is required to be physically present in the same therapy department at all times when Medicare beneficiaries receive outpatient therapeutic services. The policy was criticized by the American Hospital Association, which argued that it put an enormous burden on critical access hospitals (CAHs) and those organizations’ ability to meet the supervision requirements.

In response to pressure from lawmakers and hospitals, CMS delayed the enforcement of its supervision policy for CAHs and small rural hospitals through 2013. Thereafter, Congress stepped in, and suspended enforcement of the supervision regulation until 2014. If the bill is signed into law, it would extend the temporary relief through the end of 2015.

PARTS Act. The proposed PARTS Act would clarify that a physician or non-physician practitioner may provide general rather than direct supervision of most outpatient therapeutic services. The Act would also create an advisory panel to create exceptions for risky and complex outpatient services and would create a special rule for CAHs’ Medicare participation conditions in order to recognize their unique sizes. The Act would also exempt hospitals and CAHs from civil and criminal liability for failure to meet the current direct supervision requirement from 2001 through 2016.

Companies: American Hospital Association

MainStory: TopStory NewsStory HouseNews IPPSNews CMSNews BillingNews CoPNews CAHNews OutTherapyNews RuralNews

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