As ordered reported by the House Committee on Energy and Commerce on July 30, 2014
H.R. 4067 would require the Secretary of Health and Human Services to continue to apply through calendar year 2014 an exception to requirements that certain outpatient therapeutic services furnished in critical access and small rural hospitals need to be provided under the direct supervision of physicians in the hospital. The Centers for Medicare and Medicaid Services (CMS) currently do not enforce federal requirements related to direct supervision for those services, and CBO anticipates that CMS would not initiate enforcement of such requirements in the near future under current law. Rather, those services are subject to supervision requirements established under state laws.
Therefore, CBO estimates that enacting H.R. 4067 would have no significant effect on the federal budget. Because enacting H.R. 4067 would not affect direct spending or revenues, pay-as-you-go procedures do not apply.
The bill would not impose intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act and would impose no costs on state, local, or tribal governments.