In 2020, AMRPA continued to zealously advocate for the inpatient rehabilitation industry. AMRPA launched a number of new policy and operational initiatives and scored a number of victories for members through robust engagement with the Administration and Congressional leaders. In Congress, AMRPA has advocated for changes to coverage and reimbursement policies in order to ensure patient access to inpatient rehabilitation, and has worked actively to advance a number of bills that align with AMRPA’s policy agenda. Furthermore, as AMRPA’s membership grows, AMRPA continually identifies and fosters Congressional relationships that correlate with our expanding national presence, which will ensure that AMRPA continues to be the leading policy voice for inpatient rehabilitation. On the regulatory side, AMRPA engaged extensively with the Department of Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS) and other senior Administration officials in efforts to both champion AMRPA’s regulatory priorities – such as regulatory relief from burdensome Medicare rules – as well as successfully oppose potential policy threats, such as proposed changes to the role of the rehabilitation physician. AMRPA will continue these and other efforts as the post-acute care landscape continues to rapidly evolve in 2021 and beyond.
Looking ahead, 2021 promises to present new legislative and regulatory challenges. Your continued AMRPA membership is valued and appreciated.
Highlights of these efforts include the following:
AMRPA COVID-19 Response & Support
- Through continuous engagement with policy makers, secure robust relief for IRFs to enable the industry to continue as front-line providers in the COVID-19 Pandemic. Specific waivers and flexibilities included: waiver of the 3 Hour Rule, waiver of 60 Percent Rule, waiver of the Post-Admission Physician Evaluation, waiver to allow remote telehealth visits by physicians and virtual team conferences, waiver to permit outpatient therapy provided via telehealth, suspension of Medicare Medical Audits and Reviews, delay of implementation of the IRF-PAI version 4.0, among others.
- Distribution of a members-only weekly newsletter with updates and technical guidance on new waivers and immediate notification of significant developments.
- Creation of a COVID-19 resource center dedicated to IRF providers. Resource center included timely updates along with a comprehensive FAQ and Waiver Request Template for use by members.
- Co-host a Congressional briefing with the American Academy of Physical Medicine and Rehabilitation on the importance of IRFs and IRF providers in responding to COVID-19
- Regular member calls with extended discussion and Q&As on COVID-19 developments
- Ongoing and direct communication with CMS leaders to convey member questions and real-time operational concerns and requests.
- Response to Senate HELP Committee White Paper RFI on necessary provisions for future public health emergencies and pandemics
- Activation of Congressional grassroots advocacy to encourage additional financial relief for IRFs
- Active engagement with Congressional Members on Committees of jurisdiction via virtual meetings and PAC events
- Active engagement with other post-acute care stakeholders regarding the COVID-19 Provider Relief Fund distributions and related reporting requirements
- Continued engagement with HHS and CMS officials about harmful prior authorization practices, including presentation of data on patient access and outcomes data during the period when prior authorization was waived by many Medicare Advantage plans.
- Engagement with CMS and other officials to streamline IRF coverage requirements, including permanent removal of Post-Admission Physician Evaluation (PAPE) and streamlining of the Pre-Admission Screening
- Successfully opposed proposal to replace rehabilitation physicians with non-physician practitioners
- Engagement with CMS on refining of patients’ classification and payment rates
- Attended stakeholder roundtables with CMS to discuss changes the IRF Compare site and offered recommendations regarding the language and format of the new “CARE Compare” site
- Partnering with U.S. News & World Reports to develop new methodology for ranking rehabilitation hospitals
- Continued support for hospitals in preparing for price transparency requirements, including continued opposition to the rule and member education events.
- Opposition to potential harmful cuts proposed as part of CMS’ Physician Fee Schedule and Quality Payment Program rule.
- Ongoing engagement in response to a 2018 Office of Inspector General (OIG) report on IRF compliance with Medicare coverage criteria, and undertaking a review of certain files included in the report with the goal of improving future IRF audits.
- Serve as leaders in key coalitions, including Coalition to Preserve Rehabilitation, Consortium of Citizens with Disabilities, Disability and Rehabilitation Research Coalition, Independence through the Enhancement of Medicare and Medicaid Coalition and Fund for Access to Inpatient Rehabilitation (FAIR Fund)
- Dynamic collaboration with AAPM&R to enhance the experience of physicians practicing in IRFs
- Following robust Congressional advocacy on the need to address prior authorization reforms in Medicare Advantage, AMRPA joined numerous organizations in supporting legislation (H.R. 3107, the Improving Seniors’ Timely Access to Care Act) that would improve several of the most problematic aspects of prior authorization. The bill has secured 262 cosponsors on a bipartisan basis.
- Push for delay of the IMPACT Act implementation timeline due to COVID-19 and other factors
- Maintained and developed important relationships with Congressional leaders to provide education about the value of inpatient rehabilitation and convey the importance of the industry for the communities they represent.
- Provided members with written reports from every Medicare Payment Advisory Commission (MedPAC) session – the Congressional advisory body on Medicare issues - that touched on the unified PAC PPS and/or had implications for the inpatient rehabilitation industry
- Met with the MedPAC Executive Director and key staff to discuss the effect of COVID-19 on rehabilitation hospitals and how such experience impacts post-acute care reform efforts
- In October 2020, AMRPA hosted the 18th Annual AMRPA Educational Conference and Expo, our first ever all-virtual meeting. During this time, topics discussed ranged from payment issues in medical rehabilitation to diversity, equity, and inclusion in the hiring process. Over 1100 registrants were also invited to attend the Medical Directors’ Symposium and IRF Boot Camp. With all sessions recorded, attendees had the flexibility to watch sessions and earn continuing education credit for the remainder of the conference month.
- Throughout the year, 8 webinars were held, focusing on a variety of topics: telehealth, regulatory and legislative policy during the COVID-19 public health crisis, minimizing acute care readmissions, interdisciplinary team approaches to care.
- The policy team hosted quarterly members-only calls, providing up to the minute guidance on legislative and regulatory, updates, exceptions, and rules that play an integral role in payment and reporting in post- acute care.
- AMRPA keeps members informed of all significant policy, legislative and regulatory issues affecting medical rehabilitation providers through:
- Off the Record: an electronic weekly newsletter, which includes up to date summary information on legislative and regulatory issues affecting Medical Rehabilitation providers.
- Grassroots Action Alerts: timely electronic alerts to AMRPA members designed to mobilize national member responses to critical issues requiring Congressional action.
- AMRPA Magazine: monthly report on medical rehabilitation matters and trends, including in-depth analysis of legislative, regulatory, research, and operational issues. All issues are available online, free of charge to members.
- eRehabData’s® new suite of tools that model the impact of the new CMG rules enables rehabilitation hospitals to mitigate a potential deleterious effect on Medicare reimbursement.
- eRehabData’s® newly launched IRF QRP Certification Exam system helps hospitals gauge staff proficiency with scoring subsets of the IRF Quality Reporting Program items on the IRF-PAI and determine where education is required in the wake of major regulatory changes. Access to the IRF QRP Certification Exam system is free to subscribers, and AMRPA/eRehabData® QRP Certification status is available to users meeting or exceeding the threshold score.
- eRehabData’s® built-in electronic Pre-Admission Screening (PAS) Tool provides comprehensive and compliant pre-admission screenings. Features such as physician notificationand mobile device approval support efficient coordination between all members of the admission team. Data from the PAS Tool feed into the real-time Referrals Outcomes reports, offering information on referral and admission trends and patterns as they unfold.
- eRehabData’s® sophisticated 60% Rule compliance calculations predict both presumptive and conditional compliance using multiple risk models and always reflect the latest updates in CMS’ rules. The 60% Rule Compliance Report provides real-time calculations on your facility’s compliance status for various payer groups and compliance methodologies.
- eRehabData’s® accurate policy models provide invaluable intelligence and decision support to facilities preparing for major changes to the IRF PPS. eRehabData’s® model of the impact of switching to GG/H-based CMGs helped subscribers preserve thousands of dollars in reimbursement through optimized functional scoring prior to making the switch.
- eRehabData’s® Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) is built on a three-tiered system of data integrity checks that conforms to CMS’ requirements. eRehabData® also performs real-time analysis of your facility’s IRF-PAI data to support assessment coding and scoring best practices.
- eRehabData’s® comprehensive QRP data collection completion checks and live reports help facilities conform to data submission threshold requirements and avoid reimbursement penalties.
- eRehabData® is owned by AMRPA, which utilizes eRehabData’s® statistical analysis and policy models based on aggregated data to inform the association’s legislative and regulatory advocacy efforts on behalf of the medical rehabilitation industry.
- eRehabData’s® friendly and responsive customer support is available via email, phone, and built-in system messaging to answer your compliance, coding, and software questions.
Communications & Outreach
AMRPA Access Blog
In July 2020, AMRPA launched the AMRPA Access blog, a new feature to reach members and potential members with relevant medical rehabilitation industry news and information. Posts are being announced via social media and emails to our members and potential members.
AMRPA Consumer Microsite
Working with a taskforce from the Marketing & Communications Committee, AMRPA has launched a new consumer microsite. The site is inspirational as well as informational with Patient Success Stories and testimonials about medical rehabilitation playing important roles The microsite is also an added value for members because of our two-pronged focus:
- Promoting why and how to choose inpatient medical rehabilitation over other forms of post-acute care.
- Connecting AMRPA members with patients and their caregivers through the find a provider search function, which will be searchable by location and condition (e.g., TBI, spinal cord injury).
The microsite is a robust, intuitive and informative resource for consumers who are looking for the best options for themselves or their loved ones under trying circumstances.
Patient Success Stories
In 2020, AMRPA introduced its Patient Success Stories, a series of profiles of past medical rehabilitation hospital and unit patients, demonstrating the power of medical rehab to transform lives. Each story is promoted in social media and included on the consumer microsite and in the AMRPA Access blog. We have published four, with a fifth in the works. We continue to pursue stories from members. The stories are also included in the consumer microsite. These stories get good engagement in our social media platforms as well. They humanize the patients and are inspirational as well.
Below is some feedback that we received on our patient success stories:
“You did an amazing job!! I will remember this when I am awake at 3 AM and don't want to move - appreciate your support and hopefully this will also help others with their own goals/fight!” – Marisa Boasa, Patient at Mount Sinai Rehabilitation Hospital
“Thanks so much for forwarding this amazing story of Lex Frieden and his involvement in the ADA! It’s always heartening to see former patients thriving and making a difference for others!” – Deborah Taube, Siskin Hospital for Physical Rehabilitation
“I think these stories are beautiful and you did an amazing job pulling these together.” – Amy Dunn, Roosevelt Warm Springs Rehabilitation Hospital – Augusta Health
AMRPA’s social media presence continues to grow in terms of followers and engagement. Our LinkedIn followers have increased by more than 10 times and engagement continues to grow, particularly on Facebook.
In 2020, we will issue 12+ press releases on a variety of issues, to promote AMRPA as a leader in the medical rehabilitation industry and a valuable resource on health care issues.
- October 20, 2020: Medical Rehabilitation Leaders Welcomed as New Members to AMRPA Board of Directors
- October 8, 2020: AMRPA Honors Medical Rehabilitation Leaders at Virtual Fall Conference
- October 7, 2020: AMRPA Urges CMS to Avoid Budget Neutrality Cuts to Vital Care Services
- September 17, 2020: Hundreds of Medical Rehabilitation Leaders to Connect During AMRPA Fall Conference
- August 5, 2020: AMRPA Helps Score Major Advocacy Win for Inpatient Rehabilitation Hospitals & Rehabilitation Patients
- July 24, 2020: AMRPA Commemorates 30th Anniversary of the Americans with Disabilities Act
- June 24, 2020: AMRPA Expands COVID-19 Educational Resources to Reach Entire Medical Rehab Industry
- June 4, 2020: AMRPA Statement on Racial Injustice in the United States
- April 30, 2020: AMRPA Publically Releases COVID-19 Special Issue of its Member Magazine
- April 1, 2020: Medical Rehabilitation Hospitals Adapt Amid Crisis
- March 20, 2020: MS Patient Challenges her Prognosis and Runs Marathons
- January 9, 2020: Dr. Robert Krug becomes AMRPA Board Chair
Our efforts have resulted in increased calls from media outlets, including the Boston Globe, MedPage Today, and others, asking for statements and highlighting AMRPA’s leadership as experts in the field and a strong advocate for our members.
- April 1 press release: Published same-day by South Florida Hospital News
- Response from Modern Healthcare (building relationships with industry news leaders)
- Request from Orthopedics This Week for additional comment from Dr. Krug (positioning ourselves as industry thought leaders)
- Request from The Lund Report for an Oregon-based AMRPA member
- Request from the Allentown Morning Call for a comment on the state of the medical rehabilitation industry.