Extension of Enforcement Instruction for Outpatient Therapeutic Services in Critical Access and Small Rural Hospitals Through 2014

Floor Speech

BREAK IN TRANSCRIPT

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, H.R. 4067 would suspend current enforcement of Medicare rules relating to physician supervision of staff in rural and critical access hospitals for certain outpatient therapeutic services. Enforcement of these rules was delayed from 2009 through 2013, but began again in January of this

[Page: H7340] GPO's PDF
year. My understanding is that there has not been any issue with enforcement to date and that the Medicare program has not taken any action against a facility for failure to meet physician supervision standards since January. But as this bill did not follow regular order through the committee process, we have not had an opportunity to hear from interested parties about the issue and bring to light what the implications might be of an additional delay. Frankly, the likely result of such a bill would be confusion for hospitals.
Medicare's physician supervision requirement places a premium on patient safety, and I understand that rural facilities sometimes face difficulty in securing staffing. However, it seems reasonable to me that outpatient clinics that provide services to Medicare beneficiaries should meet some basic standards for having supervisory physicians available if an emergency arises--for example, when patients are receiving potentially lethal doses of chemotherapy medication.

Meanwhile, there are countless public health issues that the committee could productively devote its time to, such as looking into the recent outbreak of Ebola, the effects of e-cigarettes, or perhaps the decline of routine vaccinations that has led to an explosion of preventable illnesses like measles. Rather, the bill before us seems to be only responsive to the fears of certain health care providers that someone could file a complaint that a facility was allowing staff to practice medicine on Medicare patients without any supervision. But isn't that the kind of thing that we might be concerned about--and want a whistleblower to report? Yet, that is just what this bill would prevent.

It remains unclear to me why an additional delay of this Medicare policy is needed. Simply saying that the Senate passed this bill by unanimous consent in February is not sufficient justification--and makes even less sense now that the calendar year is nearly over.

So, Mr. Speaker, we should be finding time to address the real and pressing public issues facing our Nation rather than those that merely cause an inconvenience or anxiety for certain health care providers.

I reserve the balance of my time at this time, Mr. Speaker.

BREAK IN TRANSCRIPT

Source