MedPAC makes it a step closer to site-neutral for post-acute care providers
Friday, January 16, 2015 3:28 PM
The Medicare Payment Advisory Commission (MedPAC) held a second session on January 15 – on post-acute care and site-neutral payments between skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs).
What You Need to Know:
- Commissioners voted unanimously for a recommendation that would make payment site-neutral between IRFs and SNFs for a set of conditions yet to be determined by the Secretary over a three year period.
- MedPAC believes this recommendation would decrease Medicare payment by between $1 billion and $5 billion without negative impact on beneficiaries.
The Commissioners voted unanimously to support a recommendation that would eliminate the difference in payment between inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs) for selected conditions. Reductions in payment to IRFs would be phased in over three years. Note that the Secretary of the U.S. Department of Health & Human Services (HHS) would decide which conditions would be affected after notice and comment rulemaking.
The Commissioners, particularly Kathy Buto
, were cautious about this recommendation, although they all did vote to support it. Key to Commissioner Buto’s support was that CMS would conduct comprehensive notice and comment rulemaking on the technical aspects of the proposal and on the conditions ultimately selected for site-neutral payment. She also would add to the recommendation that site-neutral could occur only if “outcomes in care are comparable.” Chairman Hackbarth
declined to make changes to the recommendation language however.
MedPAC will deliver its recommendations to Congress in its March 2015 “Report to Congress.” Congress might decide to act on this site-neutral recommendation in any SGR reform legislation that it develops in response to the expiration of the SGR patch on March 31, 2015.
Please see the attached memo for additional detail on today’s site-neutral session. Click here to access the Power Point slides that were displayed at the meeting.