A bipartisan bill focusing on rural hospital relief introduced this week would further postpone the “direct supervision” for outpatient therapeutic services. In 2009, the Centers for Medicare and Medicaid Services (CMS) required Medicare hospitals to enforce “direct supervision,” where a “physician or nonphysisian practitioner must be physically present, or within immediate distance.” The concerns of rural hospitals are the limited staff to comply with these mandates. Due to this the CMS has delayed the statute continuously, and the bill brought forth would again delay the enforcement through 2021. In a statement, bill sponsor Rep. Cindy Axne, D-Iowa, said, “We need to address staffing shortages in rural areas, but in the meantime, we need to make sure that regulations aren’t overly burdensome for rural hospitals.” Nebraska Republican Adrian Smith is the lead cosponsor of the bill. He said in a statement  that “arbitrary physician supervision requirements do not account for the unique challenges faced by rural providers and place a great strain on them.” This bill would ensure that rural hospitals have the time needed to become compliant with these requirements and improve staffing. 

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