WASHINGTON, D.C. - Congressman Dave Loebsack (D-IA) released the following statement today after the President signed S. 1461 into law. Loebsack joined with Rep. Lynn Jenkins (R-KS) to introduce the House version of the legislation, which prevents Medicare's enforcement of unreasonable and inflexible direct supervision rules for outpatient therapy services at Critical Access Hospitals (CAHs) and other small, rural hospitals. This legislation was introduced this summer, passed the House and Senate this fall and was signed into law on December 18th.

"I am pleased that the President has signed this important legislation into law to ensure all Iowans have access to high-quality health care no matter where they live," said Congressman Loebsack. "Critical Access Hospitals play an important role in rural communities by providing access to primary, emergency, and acute care services. I have visited multiple CAHs across my District that have struggled to meet the direct supervision requirement, and by becoming law, this legislation will provide them with certainty that they deserve."

Item to Note:

·       There are 1,332 CAHs across the country, 82 in Iowa.

Examples of direct supervision rules for outpatient therapy services: 

·       Application of cast to a finger

·       Blood transfusions

·       Application of a splint to a finger

·       Demonstration and/or evaluation of a patient utilizing a nebulizer or metered dose inhaler

·       Alcohol and/or substance abuse (other than tobacco) structured assessment and brief intervention (such as advising of health risks and counseling for 15-30 mins)

·       Pulmonary rehabilitation, including exercise of one hour per session - up to two sessions per day


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