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Reps. Loebsack and Jenkins Introduce Bill To Help Critical Access Hospitals In Iowa & Nationwide

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Washington, July 7, 2015 | Joe Hand (202-225-6576) | comments
Congressman Dave Loebsack (D-IA) joined with Congresswoman Lynn Jenkins (R-KS) to introduce H.R. 2878 to prevent Medicare’s enforcement of unreasonable and inflexible direct supervision rules for outpatient therapy services at Critical Access Hospitals (CAHs) and other small, rural hospitals. This legislation was introduced by Loebsack and Jenkins in the 113th Congress and passed the House by a voice vote on September 9, 2014. The bill was signed by the President on December 4, 2014 and became public law. However, the law has expired and was introduced again by Congressman Loebsack and Congresswoman Jenkins.

“I am pleased to again join with Rep. Jenkins and work in a bipartisan manner to ensure all Iowans have access to high-quality health care no matter where they live,” said Congressman Loebsack. “Critical Access Hospitals play an important role in rural communities by providing access to primary, emergency, and acute care services. I have visited multiple CAHs across my District that have struggled to meet the direct supervision requirement, and this important legislation will provide them with certainty that they deserve.”

“Rural communities in Kansas and across the country depend on Critical Access Hospitals,” said Congresswoman Jenkins. “CAHs are the lifeblood of their communities, and this legislation corrects a decision from the Centers for Medicare and Medicaid Services that puts a strain on providers without providing any quality improvements for the patients they serve. I was proud to lead a bipartisan push with Senator Moran last Congress to make this bill law, extend the direct supervision requirement moratorium, and give much-needed certainty to rural hospitals. I hope that Members from both parties can once again come together to ensure that high-quality, timely care is available no matter where you live in America.”

Items to Note:
•    There are 1,332 CAHs across the country, 82 in Iowa.
•    Companion legislation was introduced in the Senate by U.S. Senator’s John Thune (R-S.D.), Jerry Moran (R-Kan.), and Jon Tester (D-Mont.). S. 1261 passed out of the Senate Finance Committee on June 24, 2015.

Examples of direct supervision rules for outpatient therapy services:
•    Application of cast to a finger
•    Blood transfusions
•    Application of a splint to a finger
•    Demonstration and/or evaluation of a patient utilizing a nebulizer or metered dose inhaler
•    Alcohol and/or substance abuse (other than tobacco) structured assessment and brief intervention (such as advising of health risks and counseling for 15-30 mins)
•    Pulmonary rehabilitation, including exercise of one hour per session – up to two sessions per day

What They Are Saying:

American Hospital Association: On behalf of our more than 5,000 member hospitals, health systems and other health care organizations, and our nearly 43,000 individual members, the American Hospital Association (AHA) is pleased to express our support for the your legislation, H.R. 2878, which would extend through calendar year (CY) 2015 the enforcement delay on direct supervision requirements for outpatient therapeutic services provided in critical access hospitals (CAHs) and rural prospective payment system (PPS) hospitals with 100 or fewer beds. Your legislation provides immediate and critical relief to small, rural hospitals and ensures patients in these communities will continue to have access to outpatient therapeutic services. As you know, these services have always been provided by licensed, skilled professionals under the overall direction of a physician and with the assurance of rapid assistance from a team of caregivers, including a physician.

National Rural Health Association: The National Rural Health Association (NRHA), a non-profit membership organization with more than 21,000 members in rural America, strongly applauds the introduction H.R. 2878 to place a moratorium on CMS’ enforcement of direct physician supervision requirements for outpatient therapy services at Critical Access Hospitals (CAHs) and other rural hospitals for 2015.  Your legislation will provide temporary relief that will go far in relieving the regulatory burden of direct supervision of outpatient therapeutic services for rural hospitals.
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