AHA urges CMS to improve LTCH proposed rule

The AHA today urged the Centers for Medicare & Medicaid Services to rescind the “25% Rule” in its proposed rule for long-term care hospitals in fiscal year 2017, which may “reduce access and payment for the very patients who the Congress has deemed appropriate for LTCH-level care and payment.” The policy “is wholly unrelated to the medical necessity of patients – absolutely nothing in it speaks to whether a particular patient requires LTCH care,” wrote AHA Executive Vice President Tom Nickels. “In fact, in its March 2011 report to Congress, the Medicare Payment Advisory Commission refers to the policy as ‘blunt’ and ‘flawed’ for this reason.” In alignment with MedPAC, AHA also urged the agency to eliminate the proposed rule’s duplicative budget neutrality adjustment, which would underpay LTCHs by 5.1% for cases in the site-neutral payment category. The association also called on CMS to improve the four new quality reporting measures proposed for FYs 2018 and 2020.