Health Information Management

Tip: Providers still seeking extension of supervision requirements exemption

APCs Insider, February 27, 2015

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Non-enforcement of supervision requirements for certain therapeutic services for critical access hospitals (CAH) and small rural hospitals continued through December 31, 2014, with the passage of H.R. 4067, but providers are looking for a permanent solution.
Beginning in 2010, CMS instructed its contractors not to enforce the supervision requirements for therapeutic services provided to outpatients in CAHs and further expanded the non-enforcement to small rural hospitals in 2011. The non-enforcement instruction expired for the CAHs on January 1, 2014, and since then, there has been a lot of activity through various lobbying groups and organizations to try and reinstate it.
The Protecting Access to Rural Therapy Services (PARTS) Act was intended to permanently change supervision levels from direct to general for therapeutic outpatient services that are not high risk or complex for certain hospitals. The outgoing Congress did not vote on PARTS, even though it was introduced. It will now have to be reintroduced under the new Congress.
This tip is adapted from “CMS updates outpatient supervision level documents" in the February issue of Briefings on APCs.

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