CHA News Article

Direct Supervision Provision Passes Congress

On Dec. 8, the House of Representatives passed S. 1461, legislation that extends through calendar year 2015 the enforcement delay on direct supervision requirements for outpatient therapeutic services provided in critical access hospitals and rural prospective payment system hospitals with 100 or fewer beds. The delay allows these hospitals to continue to receive Medicare reimbursement for services rendered under the “general” supervision of a physician, rather than requiring “direct” supervision as a condition of payment. (Direct supervision requires that the supervising physician be immediately available and have the ability to take over the procedure or provide additional orders, as well as have the knowledge, skills, ability and privileges to perform the service or procedure.)

The bipartisan legislation, supported by both CHA and the American Hospital Association, was introduced by Sens. John Thune (R-SD), Maria Cantwell (D-WA), Jerry Moran (R-KS) and Jon Tester (D-MT). Advocacy efforts continue to urge Congress to enact the Protecting Access to Rural Therapy Services (PARTS) Act, which would adopt a default standard of “general supervision” for outpatient therapeutic services, among other provisions.

CHA’s California Hospital Compliance Manual contains detailed information on the type of supervision level each hospital outpatient therapy service requires. For more information or to order the manual, visit