Washington Update: Monday, January 16, 2023
LTCH Roundtable releases issue brief on MA & LTCHs
The LTCH Roundtable – the collaborative effort between NALTH and Select Medical – released research showing MA plans’ use of LTCHs remains less than half of traditional Medicare. MA will soon account for more than 50% of Medicare beneficiaries. Beneficiaries can be expected to experience less access to LTCH care due to restrictive prior-authorization practices and narrow provider networks. A copy of the paper is attached.
Rep. Jason Smith is chosen as new House Ways & Means chair.
Rep. Jason Smith (R-MO) won a year-long, sometimes bitter, race amongst House Republicans to chair the powerful House Ways and Means Committee, which has jurisdiction over Medicare hospital policy. Rep. Smith beat Rep. Vern Buchanan (R-FL) and Rep. Adrian Smith (R-NE). Smith previously served as senior Republican on the House Budget Committee. Select Medical Executive Chair Bob Ortenzio will meet with Chairman Smith later this month.
New US House rules portend possible Medicare cuts.
The US House adopted new procedural rules intended to start reining in federal spending. One rule prohibits consideration of legislation increasing federal mandatory spending unless offsetting budget cuts are also provided. At the same time, House Republicans are considering a new US federal budget that would balance government expenditures in seven years. Such a budget would almost certainly require significant cuts to Medicare and Social Security.
MedPAC votes to recommend cuts in 2024 post-acute Medicare rates.
The Medicare Payment Advisory Commission (MedPAC) met last week and voted to recommend Medicare payment cuts for several post-acute providers. MedPAC recommended cutting inpatient rehabilitation facilities by 3%; skilled nursing facilities by 3%, and home health agencies by 7%. Congress would have to pass legislation before the cuts would take effect and Congress does not always implement MedPAC recommendations.
Home Health CEO questions value of “conveners” in MA plans.
Amedisys CEO Paul Kusserow spoke last week at the JP Morgan Health Care conference and questioned the role and value of “conveners” for home health care. He acknowledged the success of conveners like myNEXUS and NaviHealth in reducing SNF costs, but he questioned the ability of conveners to manage home health care, noting conveners lack the requisite expertise to produce good outcomes. Read more at Home Health Care News.
Study: Bloodstream infections are more likely in home health setting.
There is a refrain in Washington policy circles that home care is the future of health services. And yet there are also signs that hospitals remain better for some issues. The American Journal of Infection Control released a study showing that
central line-associated bloodstream infections (CLABSI), which cause thousands of deaths each year and are closely monitored in hospitals, aren't getting the same surveillance in the home. https://www.ajicjournal.org/article/S0196-6553(22)00806-9/fulltext
COVID-19 Public Health Emergency (PHE) extended for another 90 Days.
The Biden Administration extended the PHE, maintaining a long set of Trump-era allowances and regulatory freezes affecting much of US health care. For LTCHs, that means extension of the freeze on site-neutral payment. For IRFs, that means extension of non-enforcement of the three-hour rule. HHS has pledged it would give health providers 60 days' notice before the PHE is brought to an end.
Pennsylvania Gov. Tom Wolf (D) leaves office after eight years.
Today is the last day in office of Governor Tom Wolf, a Democrat who won re-election in 2018 by a margin of 58-41%. His first election, in 2014, was won 55-45%. Wolf leaves behind some policy wins but complicating his legacy is the sense that Harrisburg, like many state capitols, has now become as bitterly polarized as Washington. With a Republican-controlled legislature, Gov. Wolf vetoed more bills than any governor in fifty years.
Philadelphia will elect new mayor in November.
An open-seat race for mayor in Pennsylvania’s foremost Democratic bastion has attracted an expansive field of candidates. The office is currently held by Jim Kenney, a Democrat who is term-limited. Five members of the City Council have resigned to enter the race (Required by city rules). The field also includes Rebecca Rhynhart, the city’s controller, who has likewise resigned in order to run; Amen Brown, a state legislator; Jeff Brown, a supermarket chain founder; and James DeLeon; a retired judge.