S. 895Senate116th Congress (2019-2021)In Committee

Rural Hospital Regulatory Relief Act of 2019

Sponsored by John ThuneSen. John Thune (R-SD)
Introduced March 27, 2019

AI-Generated Summary

Updated April 14, 2026 at 3:23 AM UTC

The Rural Hospital Regulatory Relief Act of 2019 makes a permanent change to Medicare rules for small rural and critical‑access hospitals. It tells the Health and Human Services Secretary to keep applying an existing enforcement instruction that lets these hospitals provide outpatient therapeutic services without the usual direct physician‑supervision requirement. The bill updates the Social Security Act so the exemption continues indefinitely, affecting Medicare‑covered outpatient care at qualifying rural hospitals.

Key Provisions

  • Amends Section 1834 of the Social Security Act to add a new subsection that permanently extends the CMS enforcement instruction on supervision requirements for outpatient therapeutic services in critical‑access and small rural hospitals.
  • Directs the Secretary to continue applying the 2012 CMS notice that exempts these hospitals from the direct‑physician‑supervision rule for outpatient therapeutic services, which had previously been extended by several temporary laws.

Legislative Activity

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1 earlier action
SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance. (text: CR S2048)

March 27, 2019

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SenateIntro Referral

Introduced in Senate

March 27, 2019

SenateIntro Referral

Read twice and referred to the Committee on Finance. (text: CR S2048)

March 27, 2019

Floor Debate

7 members

What members said about S. 895 on the floor

2 Republicans5 Democrats
Ron Wyden
Sen. Ron WydenD-OR · Mar 27, 2019

Mr. President, today I, along with my colleague Senator Cotton from Arkansas, am introducing the Senate Cybersecurity Protection Act to defend the integrity of American democracy by providing…

Dianne Feinstein
Sen. Dianne FeinsteinD-CA · Mar 27, 2019

Mr. President, I am pleased to re-introduce the ``Driftnet Modernization and Bycatch Reduction Act.'' This legislation would update the Magnuson-Stevens Fishery Conservation and Management Act to…

Tim Kaine
Sen. Tim KaineD-VA · Mar 27, 2019

Mr. President, today Senator Carper and I introduced the Reclaiming Congressional Trade Authority Act of 2019. Enacting this bill would restore the role on Congress in overseeing international trade…

Richard J. Durbin
Sen. Richard J. DurbinD-IL · Mar 27, 2019

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

John Thune
Sen. John ThuneR-SD · Mar 27, 2019

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

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Steve Daines
Sen. Steve DainesR-MT · Mar 27, 2019

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Charles E. Schumer
Sen. Charles E. SchumerD-NY · Mar 27, 2019

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

John Thune
Sen. John ThuneR-SD · Mar 27, 2019

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Bill Text

Latest available legislative text

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Introduced in SenateIssued March 27, 2019

II

116th CONGRESS

1st Session

S. 895

IN THE SENATE OF THE UNITED STATES

March 27, 2019

Mr. Thune (for himself and Ms. Stabenow) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals.

1.

Short title

This Act may be cited as the Rural Hospital Regulatory Relief Act of 2019.

2.

Permanent extension of enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals

Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended by adding at the end the following new subsection:

(x)

Permanent extension of enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals

On and after the date of the enactment of this subsection, the Secretary shall continue to apply the enforcement instruction described in the notice of the Centers for Medicare & Medicaid Services entitled Enforcement Instruction on Supervision Requirements for Outpatient Therapeutic Services in Critical Access and Small Rural Hospitals for CY 2013, dated November 1, 2012 (providing for an exception to the restatement and clarification under the final rulemaking changes to the Medicare hospital outpatient prospective payment system and calendar year 2009 payment rates (published in the Federal Register on November 18, 2008, 73 Fed. Reg. 68702 through 68704) with respect to requirements for direct supervision by physicians for therapeutic hospital outpatient services), and extended by section 1 of Public Law 113–198, section 1 of Public Law 114–112, section 16004(a) of the 21st Century Cures Act (Public Law 114–255), and section 51007 of the Bipartisan Budget Act (Public Law 115–123), and reinstated for calendar years 2018 and 2019 under the final rule entitled Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs published on December 14, 2017 (82 Fed. Reg. 59216).

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