Proposal Includes Changes for Long-term Acute-care Hospitals in FY 2019

Posted on April 26, 2018

On April 24, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule to update the Medicare fee-for-service, long-term acute-care (LTCH) prospective payment system for fiscal year (FY) 2019. Highlights of the proposed rule include:

  • Elimination of the 25 percent threshold policy in FY 2019. Currently, this policy reduces payment amounts to LTCHs that admit more than a certain threshold of Medicare patients from an on-site or neighboring inpatient acute hospital during a single cost reporting period. This threshold is 25 percent for most affected LTCHs, is 50 percent for rural LTCHs, and falls between 25 and 50 percent for LTCHs located in a Metropolitan Statistical Area (MSA) with an MSA-dominant hospital.
  • A net 0.13 percent increase in the standard federal rate for facilities that successfully participate in the LTCH quality reporting program and are meaningful electronic health record users in FY 2019. This includes a proposed 0.9 percent cut to maintain budget neutrality after eliminating the 25 percent rule.
  • Removal of three measures from the LTCH quality reporting program (QRP). If finalized, the National Healthcare Safety Network (NHSN) facilitywide inpatient hospital-onset methicillin-resistant Staphylococcus aureus bacteremia outcome measure and the NHSN ventilator-associated event outcome measure would be removed from the FY 2020 QRP, and the measure on the percent of residents or patients who were assessed and appropriately given the seasonal influenza vaccine (short stay) would be removed from the 2021 QRP. As a result, LTCHs would no longer need to collect data on those three measures beginning Oct. 1, 2018.

In the near future, the MHA will distribute facility-specific impact analyses to members with LTCH operations. The association will also make its draft comments available to members prior to the June 25 submission deadline and encourages members to submit their comments to the CMS. Members with questions should contact Vickie Kunz at the MHA.

Tags: Medicare, LTCH, PPS

Posted in: Member News

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