House passes bill to delay rural hospital supervision requirements

The House passed a bill that would delay the enforcement of physician supervision requirements that many providers argue is burdensome and costly. The Senate already passed a similar measure.

The bill, sponsored by Rep. Lynn Jenkins (R-Kan.), will delay (PDF) a CMS policy that says all hospitals, including critical-access hospitals and rural hospitals, must have a doctor or non-physician practitioner immediately available when outpatient therapeutic services are provided. Those services include some emergency and observation services, including routine acts such as drawing blood. Although clinicians don't have to be in the room when the services are provided, they have to be physically close enough and ready to intervene should any problems arise.

The CMS has enforced the policy since Jan. 1. The bill passed Tuesday, however, would delay Medicare's enforcement throughout 2014. The policy previously had been delayed several times since the CMS brought it up in its 2009 outpatient payment rule.

Hospitals have argued that abiding by the direct supervision requirement is expensive because they have to hire additional staff. Rural hospitals have been especially outspoken, arguing their margins are too tight for them to afford the additional labor costs. The CMS has said the provision ensures patients have access to safe care, especially during emergencies, with the most appropriate clinicians nearby.

The American Hospital Association, National Rural Health Association and Kansas Hospital Association supported the bill. The Senate approved a similar bill in February, but it will have to take up and pass the House bill before the measure can move forward, according to a spokesman for Jenkins.

“This bill corrects a decision that puts a strain on providers and gives more certainty to folks in rural communities so they can receive the quality healthcare they deserve,” Jenkins said in a news release.

Follow Bob Herman on Twitter: @MHbherman