Jenkins, Loebsack Send Letter to HHS on Direct Supervision

Press Release

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Congress Person Lynn
Jenkins

WASHINGTON, D.C. – Recently, Congresswoman Lynn Jenkins (KS-R) and Congressman Dave Loebsack (IA-D) sent a letter to Acting Secretary of Health and Human Services Don Wright to permanently 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. The bipartisan letter was signed by 54 other members of the House of Representatives.

“Critical Access Hospitals and small hospitals are the lifeblood of rural communities,” said Congresswoman Jenkins. “Permanently preventing the “direct supervision” rule will help CAHs and other rural hospitals plan for the future and focus more on their patients. I will continue working to repeal burdensome regulations on our rural and critical access hospitals to ensure their continued presence and vitality throughout Kansas.”

“We must keep fighting to ensure all Iowans have access to high-quality health care no matter where they live,” said Loebsack. “Critical Access Hospitals play an important role in rural communities by providing access to primary, emergency, and acute care services. I have visited CAHs across the state that has struggled to meet the direct supervision requirement. I am proud to continue working with Rep. Jenkins on a bipartisan basis to permanently extend this rule to provide CAHs with certainty that they deserve.”

Dear Acting Secretary Wright:

On July 13, 2017, the Centers for Medicare and Medicaid Services released the proposed rule for “Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Changes for 2018.” While we were pleased CMS included a two-year moratorium on enforcement of its burdensome direct supervision requirement for outpatient therapeutic services provided in certain small and rural hospitals, we urge you to include a moratorium for the current year, 2017, and to permanently extend the enforcement moratorium.

Under current regulations, hospitals must perform most outpatient therapeutic services under the “direct supervision” of a physician or qualified non-physician practitioner, which can be challenging for small and rural hospitals due to already low numbers of available health professionals and associated costs. When these services become too expensive or difficult to provide under “direct supervision” requirements, they are at risk of being terminated, leaving patients without access to care in their communities.

The American Hospital Association, which represents nearly 2,000 small and rural hospitals, has stated that hospital outpatient services in rural communities have always been – and will continue to be provided by licensed, skilled professionals under the overall direction of a physician. However, if CMS enforces its burdensome direct supervision policy in these vulnerable facilities, we are concerned that many hospitals will simply stop offering certain services or drastically limit when they are offered to patients because they cannot afford to maintain compliance with the regulation. Furthermore, we are concerned that without a moratorium in 2017, hospitals operations and services may be jeopardized by the prospect of enforcement of this burdensome regulation.

We appreciate your willingness to listen to and consider our concerns, and for your commitment to protect access to patient care in rural communities and provide regulatory relief to America’s small and rural hospitals.