General Supervision Fix
NRHA applauds Senator Moran (KS) for introducing S. 778, the Protecting Access to Rural Therapy Services Act and strongly supports its passage. In 2010, the Centers for Medicare and Medicaid Services (CMS) released a final regulation for the Outpatient Prospective Payment System. In the regulation, CMS required that all hospitals provide “direct physician supervision” of certain outpatient therapeutic services in order to receive Medicare reimbursement. The term “direct supervision” meant that a supervising physician of non-physician professional (NPP) must be “immediately available…without passage of time.” With the current workforce shortages in many rural hospitals, NRHA is concerned with the burden that this rule places on physicians and hospitals. Senator Moran's legislation would allow certain types of outpatient therapy to be administered by professional hospital staff under the "general supervision" of a physician or NPP. This means that a physician or NPP provides overall direction and control of the therapy but need not be physically present or immediately available while therapy is taking place. This legislation appropriately balances the need for direct supervision of certain therapeutic services with the flexibility that rural hospitals need when administering low-risk therapy. NRHA strongly supports this legislation and will continue to advocate for its passage.