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
A coalition of hospital and physician organizations, including the AHA, yesterday urged the Centers for Medicare & Medicaid Services to give Medicare…
Headline
The AHA, joined by the Federation of American Hospitals, Michigan Health & Hospital Association, Kentucky Hospital Association, Ohio Hospital Association…
Headline
The AHA continues to spotlight the important work of rural hospitals tasked with caring for the nearly 60 million Americans who live in rural communities. The…
Headline
The AHA today restated its strong support for the Centers for Medicare & Medicaid Services’ withdrawal of its Most Favored Nation Model proposed rule. In…
Headline
The Centers for Medicare & Medicaid Services should withdraw a proposed Medicare demonstration that would implement new program integrity audits for all…
Headline
Health care providers registered with the Drug Enforcement Administration must use the new single-sheet form to order schedule I and II controlled substances,…