House approves bill extending relief from LTCH 25% rule

The House Ways and Means Committee today approved legislation (H.R. 5713) that would extend the 25% Rule relief that has been in place for long-term care hospitals. The nine-month extension would apply to LTCH discharges between Oct.1, 2016 and June 30, 2017. Among other provisions, the bill would eliminate the exception to the revised average length of stay requirement, which prevents LTCHs established after Dec. 10, 2013 from excluding site-neutral and Medicare Advantage patients from their average length of stay. It also would create a temporary exception to site-neutral payment for certain LTCHs specializing in spinal cord injuries and for severe wound care cases at certain grandfathered hospitals-within-hospitals LTCHs. In addition, the bill would align the statute with recently changed regulations that pertain to the single “cancer LTCH.” To offset the cost of these changes, the bill would prohibit newly enrolled providers and suppliers in areas where the Centers for Medicare & Medicaid Services has imposed a temporary enrollment moratorium from billing Medicare, Medicaid or beneficiaries. The AHA has long supported regulatory relief from the 25% Rule, which applies a payment penalty averaging 40% to referrals from a general acute-care hospital that exceed a certain threshold.