AMRPA 2021 Policy Priorities
Advance Evidence-Based Post-Acute Care Payment Reforms & Protect Patient Access to Medically Appropriate Inpatient Rehabilitation Care
Protecting patient access to medically necessary inpatient rehabilitation hospital care without unnecessary delays is AMRPA’s top policy focus in 2021. AMRPA has created the following policy agenda to promote this goal.
- Revise the IMPACT Act Timeline to Account for the Public Health Emergency and Avoid Significant Disruptions in Care Delivery
- Revise the IMPACT Act timeline so that it includes data and information from the COVID-19 pandemic.
- Working with other PAC stakeholders and policymakers, develop an alternative to the IMPACT Act’s approach to PAC payment system reform that is patient-centric.
- Ensure that Oversight and Program Integrity Efforts by CMS Result in Fair and Accurate Reviews and Do Not Create Barriers for Patients to Access Medically Necessary Inpatient Rehabilitation Hospitals
- Urge CMS to withdraw the proposed inpatient rehabilitation hospital and unit (IRF) Review Choice Demonstration.
- If CMS does not withdraw the proposal altogether, delay the demonstration and scale back the proposed program.
- Improve audit processes to protect inpatient rehabilitation hospitals from unnecessary administrative burden.
- Improve Medicare Advantage Prior Authorization Practices to Protect Patient Access to Medically Necessary Inpatient Rehabilitation Hospital Care
- Pass legislation that reforms Medicare Advantage prior authorization policies and practices to ensure that patients receive access to medically appropriate post-acute care without arbitrary denials and/or unnecessary delays.
- Promote Payment Policies that are Fair to Patients, Providers, Payers, and the Medicare Trust Fund
- Advocate for alternatives to “across the board” payment reductions and instead work with stakeholders to advance meaningful reforms.
- Waive budget neutrality requirements for the Medicare Physician Fee Schedule or pass legislation to solve the problem.
- Learn from the COVID-19 Pandemic to Modernize Medicare Regulations for Inpatient Rehabilitation Hospitals
- Make permanent the temporary policy waivers and flexibilities that improved timely access for patients to inpatient rehabilitation hospitals.
- Advocate for legislation to allow inpatient rehabilitation hospitals to provide the most appropriate and individualized therapy services to patients while remaining in compliance with IRF intensity of therapy requirements.
- Expand the list of conditions that qualify for 60-Percent Rule compliance, so that patients who would benefit from inpatient rehabilitation care can adequately access it.
- Advocate for Fair Distribution of the COVID-19 Financial Provider Relief Funds and Reasonable Reporting Requirements
- Improve reporting requirements for the Provider Relief Fund and address IRF-specific challenges.
- Ensure the Provider Relief Fund is adequately funded so that inpatient rehabilitation hospitals can continue providing safe care throughout the duration of the public health emergency and beyond.
- Enhance Telehealth Regulations Permanently to Allow Patients to Receive Care in the Location Most Appropriate for their Needs
- Support legislation to permanently expand access to telehealth services in all settings, including physician visits and for physical therapy, occupational therapy, and speech-language pathology services.