[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3769 Introduced in House (IH)]

113th CONGRESS
  1st Session
                                H. R. 3769

   To extend the nonenforcement instruction for the Medicare direct 
 supervision requirement for therapeutic hospital outpatient services 
insofar as it applies to critical access hospitals and rural hospitals, 
to require a study of the impact on critical access hospitals and rural 
   hospitals of a failure to extend such instruction, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           December 12, 2013

  Mr. Smith of Nebraska (for himself and Ms. Jenkins) introduced the 
   following bill; which was referred to the Committee on Energy and 
  Commerce, and in addition to the Committee on Ways and Means, for a 
 period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
   To extend the nonenforcement instruction for the Medicare direct 
 supervision requirement for therapeutic hospital outpatient services 
insofar as it applies to critical access hospitals and rural hospitals, 
to require a study of the impact on critical access hospitals and rural 
   hospitals of a failure to extend such instruction, and for other 
                               purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. EXTENSION OF NONENFORCEMENT INSTRUCTION FOR THE MEDICARE 
              DIRECT SUPERVISION REQUIREMENT FOR THERAPEUTIC HOSPITAL 
              OUTPATIENT SERVICES FOR CRITICAL ACCESS HOSPITALS AND 
              RURAL HOSPITALS; STUDY OF IMPACT OF FAILURE TO EXTEND 
              SUCH INSTRUCTION.

    (a) Extension of Therapy Supervision Nonenforcement Instruction.--
The Secretary of Health and Human Services shall, during the extension 
period, extend the therapy supervision nonenforcement instruction.
    (b) Definitions.--In this section:
            (1) Therapy supervision nonenforcement instruction.--The 
        term ``therapy supervision nonenforcement instruction'' means 
        the enforcement instruction on supervision requirements for 
        outpatient therapeutic services in critical access and small 
        rural hospitals, as extended for calendar year 2013 by the 
        Centers for Medicare & Medicaid Services (released as of 
        November 1, 2012).
            (2) Critical access hospital; small rural hospital.--The 
        terms ``critical access hospital'' and ``small rural hospital'' 
        have the meanings given such terms for purposes of the therapy 
        supervision nonenforcement instruction.
            (3) Extension period.--The term ``extension period'' means 
        calendar year 2014, and includes a subsequent calendar year 
        unless the report under subsection (c)(2) has been submitted at 
        least 90 days before the end of the previous calendar year.
    (c) Study and Report on Impact of Failure To Extend Therapy 
Supervision Nonenforcement Instruction.--
            (1) Study.--The Secretary of Health and Human Services 
        shall conduct a study on the impact (including the economic 
        impact and the impact upon hospital staffing needs, if any) on 
        critical access hospitals and small rural hospitals of not 
        extending the therapy supervision nonenforcement instruction.
            (2) Report.--The Secretary of Health and Human Services 
        shall submit to Congress a report on the findings of the study 
        conducted under paragraph (1), including recommendations 
        regarding on whether the therapy supervision nonenforcement 
        instruction should be extended or made permanent.
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