Washington Update: Monday, June 12, 2023
LTCH community trying to reach consensus on future legislative proposals.
Select Medical is working with AHA, NALTH, Scion and others to cobble together a consensus among the nation’s LTCHs about what policymakers should do to address the challenges facing the LTCH community. One idea being considered is a payment adjustment to reflect the higher costs of more complex patients. In order to be considered for the Fall Congressional session, Select Medical has been urging all LTCHs to reach a consensus soon.
AMRPA and IRF sector prepare for IRF-RCD audits.
A new round of IRF audits – known as “Review Choice Demonstration” (RCD) – are set to begin in August. AMRPA is briefing IRFs on how to comply. The IRF- RCD audits will begin in Alabama but is expected to be expanded to Pennsylvania and other states in the coming months. Impacted IRFs must decide by August whether they will have their claims reviewed using a pre-claim or post-claim process. Initially, 100% of claims must be reviewed. After six months of demonstrated compliance, CMS has indicated that IRFs will be able to elect to move to less extensive, spot-review process.
Medicare Part B debate continues with little likelihood of progress this year.
In past few years, the outpatient therapy community successfully lobbied for legislation which partially mitigated future Part B cuts. APTA is focused now on a bill (HR 2474) to increase provider payments based on medical inflation which current Medicare policy is not keeping up with. Select Medical has been happy to support the AMA-APTA effort but it’s hard to imagine the bill gaining traction without a larger Medicare consensus between Democrats and Republicans.
Republican Freedom Caucus brings US House votes to a halt.
Even though the contentious debt debate is behind us, the drama in the US House has not ended. Last week, to show their disapproval of the deal and of Speaker McCarthy, members of the Freedom Caucus used parliamentary tactics to bring proceedings on the House floor to a halt, in the first protest of its kind in more than two decades. Finally, mid-week, Speaker McCarthy sent the House home, hoping that cooler heads would prevail this week when the US House reconvenes.
Supreme Court issues surprise decision on race & Congressional districting.
The Supreme Court ruled 5-4 last week that Alabama had diluted the power of African-American voters in drawing a congressional voting map, reaffirming a landmark civil rights law. The impact of the decision will not be limited to Alabama as other states in the South, notably Louisiana and Georgia, may also have to redraw their maps to bolster Black voting power. This could help Democrats in their efforts to retake the narrowly-divided US House in 2024.
PBM transparency bill clears major House committee.
One healthcare bill looks like it has legs in this session of Congress: A bill requiring Pharmacy Benefit Managers (PBMs) to disclose more pricing information. The legislation was approved – unanimously – by the House Energy and Commerce Committee. The bill is supported by the pharmaceutical industry. White House support of the bill is seen as a goodwill gesture to drugmakers – after the White House imposed Medicare price limits on some medicines.
PA: Mayor’s race was most expensive in Philadelphia history.
Last month, Philadelphia held a Democratic primary election and nominated Cherelle Parker. The five major candidates spent a record-level $31 million, the most expensive city election in Philadelphia history. The Philadelphia Inquirer says the huge amount of money that poured into the race is due to three primary factors: an unusually high number of viable candidates, an influx of “Super PAC” spending, and self-funding by candidates.
Nature: New technology opens new frontiers for paralyzed patients.
We wanted to note some good news: A study published in Nature, showing how two implants into the brain and spinal cord of a paralyzed man enabled him to walk more naturally. The study in Nature marries spinal stimulation with what is known as brain-computer interface. As our clinicians know better than we do, such science fiction-like achievements have huge potential for the field of medical rehabilitation.