In a letter to the editor published March 3 by KFF Health News, Jim Prister, president and CEO of RML Specialty Hospital and chair of the AHA Post-Acute Steering Committee, urged Congress to address chronic underpayments and insurance barriers that are harming patient care and access to long-term care hospitals. Prister highlighted the importance of LTCHs and how they offer highly personalized care to individuals recovering from a catastrophic illness or injury, and he detailed changes by Congress to reimbursement and other issues that have negatively impacted LTCHs. “Furthermore, insurance company barriers — such as prior authorization requirements put in place by Medicare Advantage plans — are creating harmful delays and denials of necessary and time-sensitive patient care,” Prister wrote. “Consequently, many patients are denied access to an LTCH setting — or transferred to other post-acute care settings like rehabilitation or skilled nursing facilities that aren’t equipped to care for patients with highly complex needs like ventilation.” 

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The Centers for Medicare & Medicaid Services May 13 announced 29 health care organizations have pledged early participation in its electronic prior…
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