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"

 

In the 2009 outpatient prospective payment system final rule, the Centers for Medicare & Medicaid Services (CMS) clarified existing policy for physician supervision of outpatient therapeutic services as a condition of payment.  CMS policy requires direct supervision by an appropriate physician or non-physician practitioner in the provision of all therapeutic services to hospital outpatients, including Critical Access Hospitals (CAH). As a result of concerns raised by CAHs and small rural hospital providers, CMS delayed the enforcement of the supervision requirements in a non-enforcement instruction on March 15, 2010, for critical access hospitals and small rural providers. This non-enforcement instruction was in place from that time through 2013.

 

H.R. 4067, introduced by Rep. Lynn Jenkins (R-KS), requires the Secretary of Health and Human Services to halt the enforcement of these supervision requirements for the remainder of calendar year 2014.

 

Non-enforcement of supervision requirements can have patient safety implications.  For example, this would mean that hospital outpatient departments giving toxic doses of chemotherapy medicine would not have to ensure there is a supervising professional in the facility when the patient was being treated.

 

The House considered H.R. 4067 on September 9, 2014, and passed the legislation by a voice vote.