Sens. John Thune (R-SD) and Heidi Heitkamp (D-ND) and Reps. Lynn Jenkins (R-KS), Dave Loebsack (D-IA) and Adrian Smith (R-NE) last night introduced AHA-supported legislation (S. 243/H.R.741) to permanently extend the enforcement moratorium on “direct supervision” of outpatient therapeutic services for critical access hospitals and small, rural hospitals with 100 or fewer beds. “Your legislation would provide immediate and permanent regulatory relief to small, rural hospitals and ensure these communities will continue to have access to outpatient therapeutic services,” said AHA Executive Vice President Tom Nickels in letters of support to the sponsors. “As you know, these services have always been provided by licensed, skilled professionals under the overall supervision of a physician and with the assurance of rapid assistance from a team of caregivers, including a physician. While hospitals recognize the need for direct supervision for certain outpatient services that pose a high risk or are very complex, the Centers for Medicare & Medicaid Services policy generally applies to even the lowest risk services.”