WASHINGTON, D.C. – U.S. Senator Jerry Moran, who serves on the Senate Rural Health Caucus, today introduced S. 1143, the Protecting Access to Rural Therapy Services (PARTS) Act, to make sure that rural and other patients have access to a full range of outpatient therapeutic services in their own communities.
“Outpatient therapeutic services” include services such as drug infusions, blood transfusions, and cardiac and pulmonary rehabilitation services. U.S. Senators Jon Tester (D-Mont.) and John Thune (R-S.D.) joined as original cosponsors of this bipartisan bill.
These health care services have always been administered by licensed, skilled medical professionals in hospitals under the overall direction of a physician. However, in its attempt to clarify existing regulations in 2009, the Centers for Medicare & Medicaid Services (CMS) retroactively interpreted existing policy in place since 2001 to require that a supervising physician be physically present in the department at all times when Medicare beneficiaries receive outpatient therapy services, the majority of which are low risk.
“CMS’ policy does not take into account the realities of rural health care. Many Kansas hospitals, and other rural hospitals across the country, find these supervision requirements impossible to meet – jeopardizing continued access to these important health care services,” Sen. Moran said.
“Small and rural hospitals, where medical workforce shortages are most severe, need reasonable flexibility to appropriately staff their facilities so they can continue to provide a full range of services to their communities. The PARTS Act is a commonsense solution that would preserve patient safety and ease unreasonable regulations on hospitals.”
“CMS’ physician supervision policy poses a threat to the delivery of health care in rural Kansas hospitals,” said Kevin Miller, president and chief executive officer of Hutchinson Regional Medical Center. “We need a permanent solution that recognizes how we operate hospitals in rural America. The PARTS Act fixes this problem by providing rural hospitals with the flexibilities necessary to continue providing the much needed therapy services to patients in their own communities.”
“In rural Kansas, the ability to provide accessible, timely care is critical. The PARTS Act creates a reasonable approach to the physician supervision requirements,” said Denny Hachenberg, chief executive officer at Anderson County Hospital. “Without this legislation, our hospital would face difficulties in meeting the challenging requirements, thus causing many of our patients to delay care or seek the services outside of our local community.”
In response to concerns raised by Sen. Moran, other lawmakers from rural states, and hospitals, CMS delayed enforcement of its direct supervision policy through 2013 for Critical Access Hospitals (CAHs) and other small, rural hospitals. However, the regulations are scheduled to go into effect in 2014.
The PARTS Act would:
Allow general supervision by a physician or non-physician providers for many outpatient therapy services;
Require CMS to allow a default setting of general supervision, rather than direct supervision, for outpatient therapy services;
Create an advisory panel to establish an exemption process for risky and complex outpatient services;
Create a special rule for CAHs that recognizes their unique size and Medicare conditions of participation; and
Hold hospitals and CAHs harmless from civil or criminal action regarding CMS’ current direct supervision policy for the period 2001 through 2014.