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II
116TH CONGRESS
1ST SESSION
S. 895
To provide for a permanent extension of the enforcement instruction on
supervision requirements for outpatient therapeutic services in critical
access and small rural hospitals.
IN THE SENATE OF THE UNITED STATES
MARCH 27, 2019
Mr. THUNE (for himself and Ms. STABENOW) introduced the following bill;
which was read twice and referred to the Committee on Finance
A BILL
To provide for a permanent extension of the enforcement
instruction on supervision requirements for outpatient
therapeutic services in critical access and small rural
hospitals.
Be it enacted by the Senate and House of Representa-
1
tives of the United States of America in Congress assembled,
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SECTION 1. SHORT TITLE.
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This Act may be cited as the ‘‘Rural Hospital Regu-
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latory Relief Act of 2019’’.
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•S 895 IS
SEC. 2. PERMANENT EXTENSION OF ENFORCEMENT IN-
1
STRUCTION
ON
SUPERVISION
REQUIRE-
2
MENTS
FOR
OUTPATIENT
THERAPEUTIC
3
SERVICES IN CRITICAL ACCESS AND SMALL
4
RURAL HOSPITALS.
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Section 1834 of the Social Security Act (42 U.S.C.
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1395m) is amended by adding at the end the following
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new subsection:
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‘‘(x) PERMANENT EXTENSION OF ENFORCEMENT IN-
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STRUCTION ON SUPERVISION REQUIREMENTS FOR OUT-
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PATIENT THERAPEUTIC SERVICES IN CRITICAL ACCESS
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AND SMALL RURAL HOSPITALS.—On and after the date
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of the enactment of this subsection, the Secretary shall
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continue to apply the enforcement instruction described in
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the notice of the Centers for Medicare & Medicaid Services
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entitled ‘Enforcement Instruction on Supervision Require-
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ments for Outpatient Therapeutic Services in Critical Ac-
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cess and Small Rural Hospitals for CY 2013’, dated No-
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vember 1, 2012 (providing for an exception to the restate-
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ment and clarification under the final rulemaking changes
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to the Medicare hospital outpatient prospective payment
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system and calendar year 2009 payment rates (published
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in the Federal Register on November 18, 2008, 73 Fed.
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Reg. 68702 through 68704) with respect to requirements
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for direct supervision by physicians for therapeutic hos-
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pital outpatient services), and extended by section 1 of
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•S 895 IS
Public Law 113–198, section 1 of Public Law 114–112,
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section 16004(a) of the 21st Century Cures Act (Public
2
Law 114–255), and section 51007 of the Bipartisan
3
Budget Act (Public Law 115–123), and reinstated for cal-
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endar years 2018 and 2019 under the final rule entitled
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‘Medicare Program: Hospital Outpatient Prospective Pay-
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ment and Ambulatory Surgical Center Payment Systems
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and Quality Reporting Programs’ published on December
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14, 2017 (82 Fed. Reg. 59216).’’.
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Æ
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