AHA Oct. 27 urged the Medicare Payment Advisory Commission to reconsider its pursuit of site-neutral payment policies for inpatient rehabilitation facilities and skilled-nursing facilities. At their meeting this month, commissioners discussed whether conditions that fall outside the 13 that must account for 60% of IRF patients should be paid at the skilled-nursing facility rate. 

“The AHA appreciates that MedPAC continues to pursue proposals that could potentially improve the alignment of cost and payment under the IRF prospective payment system,” AHA wrote. “However, we have numerous concerns about the commission’s analysis; AHA believes a site-neutral policy would ultimately be harmful to seriously afflicted Medicare beneficiaries.”

Among other topics, the commission discussed the Centers for Medicare & Medicaid Services’ recent proposed rule that would impose minimum staffing standards on long-term care facilities and staff plans to analyze staffing data. AHA encouraged MedPAC to focus its analyses on the effects minimum staffing requirements have had on facility capacity and, subsequently, patient access to care, including likely effects on discharge delays from general acute care hospitals.

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