AHA today raised “substantial concerns” with the prototype payment model that the Centers for Medicare & Medicaid Services, Department of Health and Human Services Assistant Secretary for Planning and Evaluation, and RTI International are developing for the new unified post-acute care prospective payment system required by the Improving Medicare Post-Acute Care Transformation Act of 2014.

“In particular, we are not confident that the eventual prototype will be capable of yielding accurate payments for the full array of patients treated across the four PAC settings,” AHA wrote, imploring CMS, ASPE and RTI to address its questions, issues and concerns at the next meeting of the RTI Technical Expert Panel. 

The letter enumerates multiple gaps in the methodology used thus far to build the new PAC payment prototype. 

“If some portion of these design challenges is found to be insurmountable, or cannot be adequately mitigated, our current ask of Congress to reconsider and refine the IMPACT Act timeline related to PAC PPS development would become even more urgent,” AHA said.
 

Related News Articles

Headline
The Senate Appropriations Committee July 31 advanced the fiscal year 2026 appropriations bill for the Departments of Labor, Health and Human Services,…
Headline
The Department of Health and Human Services today issued a notice announcing a 340B Rebate Model Pilot Program as a voluntary mechanism for qualifying drug…
Chairperson's File
Public
The recently enacted One Big Beautiful Bill Act will bring big changes to health care. AHA President and CEO Rick Pollack joined me for a Leadership Dialogue…
Headline
The Senate Health, Education, Labor and Pensions Committee yesterday voted 12-11 along party lines to recommend the confirmation of Brian Christine, M.D., to…
Headline
Rep. Doris Matsui, D-Calif., and Sen. Peter Welch, D-Vt., today introduced the 340B Patients Act, AHA-supported legislation that would codify 340B providers'…
Headline
The AHA July 16 filed an amicus brief in the U.S. District Court for the District of Colorado in defense of the state’s 340B contract pharmacy law prohibiting…