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S. Rept. 114-109 1 (2015-07-30)

handle is hein.congrecreports/crptxsba0001 and id is 1 raw text is: AUT-ENTICATED US. GOVERNMENT INFORMATION GP Calendar No. 188 114TH CONGRESS REPORT 1st Session SENATE 114-109 A BILL TO PROVIDE FOR THE EXTENSION OF THE ENFORCEMENT IN- STRUCTION ON SUPERVISION REQUIREMENTS FOR OUTPATIENT THERAPEUTIC SERVICES IN CRITICAL ACCESS AND SMALL RURAL HOS- PITALS THROUGH 2015 JULY 30, 2015.-Ordered to be printed Mr. HATCH, from the Committee on Finance, submitted the following REPORT [To accompany S. 1461] The Committee on Finance, to which was referred the bill (S. 1461) to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015, having con- sidered the same, reports favorably thereon with an amendment and recommends that the bill, as amended, do pass. I. LEGISLATIVE BACKGROUND The Committee on Finance, to which was referred (S. 1461), to provide for the extension of the enforcement instruction on super- vision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015, reports favorably thereon with an amendment and recommends the bill, as amended, do pass. Background and need for legislative action In the calendar year (CY) 2009 Medicare hospital outpatient pro- spective payment system (OPPS) final rule, the Centers for Medi- care and Medicaid Services (CMS) restated and clarified a 2001 policy that required direct physician supervision for outpatient therapeutic services furnished in a hospital outpatient department unless another supervision level is specified for the service. The final rule discussed that direct supervision means a physician or a non-physician practitioner must be immediately available to fur- nish assistance and direction throughout a procedure in the hos- pital outpatient department. CAHs and small rural hospitals raised concerns that the policy increased confusion about the types of 49-010

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