{"id":14354,"date":"2018-09-13T14:39:58","date_gmt":"2018-09-13T18:39:58","guid":{"rendered":"http:\/\/www.medicareadvocacy.org\/?p=14354"},"modified":"2021-08-11T12:39:04","modified_gmt":"2021-08-11T16:39:04","slug":"medpac-discusses-requiring-a-three-day-hospital-stay-for-all-post-acute-care-threatening-access-to-care","status":"publish","type":"post","link":"https:\/\/medicareadvocacy.org\/medpac-discusses-requiring-a-three-day-hospital-stay-for-all-post-acute-care-threatening-access-to-care\/","title":{"rendered":"MedPAC Discusses Requiring a Three-Day Hospital Stay for All Post-Acute Care, Threatening Access to Care"},"content":{"rendered":"<p>The Medicare Payment Advisory Commission (MedPAC) held a public meeting on September 6, 2018. Commissioners listened as staff presented on &ldquo;Aligning Medicare&rsquo;s statutory and regulatory requirements under a unified payment system for post-acute care.&rdquo;<a href=\"file:\/\/cmactsrv01\/wdox\/docs\/cma\/999\/00000\/00318548.DOCX#_ftn1\" name=\"_ftnref1\" title=\"\">[1]<\/a> Specifically, the presentation discussed the need to make level-of-care requirements consistent across post-acute care (PAC) settings under a unified PAC prospective payment system (PPS). The objective of the unified PAC PPS is to &ldquo;set payments based on patient characteristics, not site of care.&rdquo;<a href=\"file:\/\/cmactsrv01\/wdox\/docs\/cma\/999\/00000\/00318548.DOCX#_ftn2\" name=\"_ftnref2\" title=\"\">[2]<\/a> MedPAC envisions that a &ldquo;common set of requirements . . . [would] apply to all providers.&rdquo;<a href=\"file:\/\/cmactsrv01\/wdox\/docs\/cma\/999\/00000\/00318548.DOCX#_ftn3\" name=\"_ftnref3\" title=\"\">[3]<\/a><\/p>\n<p>In discussing what policies might ensure appropriate PAC use under the unified PAC PPS, MedPAC staff suggested &ldquo;requiring a three-day stay for PAC to ensure appropriate use.&rdquo;<a href=\"file:\/\/cmactsrv01\/wdox\/docs\/cma\/999\/00000\/00318548.DOCX#_ftn4\" name=\"_ftnref4\" title=\"\">[4]<\/a> The presentation highlighted that the three-day hospital stay requirement may be mitigated by allowing observation days to count towards the requirement and allowing accountable care organizations or entities at financial risk to waive the requirement.<a href=\"file:\/\/cmactsrv01\/wdox\/docs\/cma\/999\/00000\/00318548.DOCX#_ftn5\" name=\"_ftnref5\" title=\"\">[5]<\/a> Even with limited exceptions, MedPAC&rsquo;s proposal would create a substantial barrier to care for countless Medicare beneficiaries who need post-acute care would not meet an arbitrary three-day hospital stay requirement.<\/p>\n<p>In order to qualify for skilled nursing facility coverage, beneficiaries must have a qualifying three-day inpatient hospital stay. There is currently no similar three-day hospital stay requirement for care at inpatient rehabilitation facilities, long-term care hospitals, or for home health. In fact, Congress specifically removed a prior Part A hospital stay requirement for home health in 1980.<a href=\"file:\/\/cmactsrv01\/wdox\/docs\/cma\/999\/00000\/00318548.DOCX#_ftn6\" name=\"_ftnref6\" title=\"\">[6]<\/a> Adding a hospital stay requirement now for home health or any other post-hospital care setting is a step back for the Medicare program and beneficiaries. &nbsp;It is also contrary to health policy goals of avoiding and reducing hospitalization, the most expensive setting for care.<\/p>\n<div><span style=\"font-size:10px;\"><em>September 13, 2018 &#8211; D. Lipschutz<\/em><\/span><\/p>\n<p>&nbsp;<\/p>\n<hr align=\"left\" size=\"1\" width=\"33%\" \/>\n<div id=\"ftn1\">\n<p><span style=\"font-size:10px;\"><a href=\"file:\/\/cmactsrv01\/wdox\/docs\/cma\/999\/00000\/00318548.DOCX#_ftnref1\" name=\"_ftn1\" title=\"\">[1]<\/a> Evan Christman, <em>Aligning Medicare&rsquo;s statutory and regulatory requirements under a unified payment system for post-acute care<\/em>, MedPAC (Sept. 6, 2018), <a href=\"http:\/\/www.medpac.gov\/docs\/default-source\/default-document-library\/aligning-pac-requirements_fin.pdf?sfvrsn=0\">http:\/\/www.medpac.gov\/docs\/default-source\/default-document-library\/aligning-pac-requirements_fin.pdf?sfvrsn=0<\/a>.<br \/>\n\t\t\t<a href=\"file:\/\/cmactsrv01\/wdox\/docs\/cma\/999\/00000\/00318548.DOCX#_ftnref2\" name=\"_ftn2\" title=\"\">[2]<\/a> <em>Id.<\/em><\/span><br \/>\n\t\t\t<span style=\"font-size:10px;\"><a href=\"file:\/\/cmactsrv01\/wdox\/docs\/cma\/999\/00000\/00318548.DOCX#_ftnref3\" name=\"_ftn3\" title=\"\">[3]<\/a> <em>Id.<\/em><\/span><br \/>\n\t\t\t<span style=\"font-size:10px;\"><a href=\"file:\/\/cmactsrv01\/wdox\/docs\/cma\/999\/00000\/00318548.DOCX#_ftnref4\" name=\"_ftn4\" title=\"\">[4]<\/a> <em>Id.<\/em><\/span><br \/>\n\t\t\t<span style=\"font-size:10px;\"><a href=\"file:\/\/cmactsrv01\/wdox\/docs\/cma\/999\/00000\/00318548.DOCX#_ftnref5\" name=\"_ftn5\" title=\"\">[5]<\/a> <em>Id.<\/em><\/span><br \/>\n\t\t\t<span style=\"font-size:10px;\"><a href=\"file:\/\/cmactsrv01\/wdox\/docs\/cma\/999\/00000\/00318548.DOCX#_ftnref6\" name=\"_ftn6\" title=\"\">[6]<\/a> The Omnibus Reconciliation Act of 1980, Pub. L. No. 96-499. <em>See also<\/em> <em>Medicare Home Health Coverage is Not a Short-Term, Acute Care Benefit \u2500 Congress Acted in 1980 to Provide for Longer-Term Coverage<\/em>, Center for Medicare Advocacy, <a href=\"https:\/\/www.medicareadvocacy.org\/alert-spotlight-on-medicare-home-health-care-tax-cuts-set-stage-for-medicaremedicaid-cuts-aca-news\/#1\">https:\/\/www.medicareadvocacy.org\/alert-spotlight-on-medicare-home-health-care-tax-cuts-set-stage-for-medicaremedicaid-cuts-aca-news\/#1<\/a> (last visited Sept. 11, 2018).<\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<\/p><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>The Medicare Payment Advisory Commission (MedPAC) held a public meeting on September 6, 2018. Commissioners listened as staff presented on &ldquo;Aligning Medicare&rsquo;s statutory and regulatory requirements under a unified payment system for post-acute care.&rdquo;[1] Specifically, the presentation discussed the need to make level-of-care requirements consistent across post-acute care (PAC) settings under a unified PAC prospective [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[3],"tags":[33,54],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>MedPAC Discusses Requiring a Three-Day Hospital Stay for All Post-Acute Care, Threatening Access to Care - Center for Medicare Advocacy<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicareadvocacy.org\/medpac-discusses-requiring-a-three-day-hospital-stay-for-all-post-acute-care-threatening-access-to-care\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"MedPAC Discusses Requiring a Three-Day Hospital Stay for All Post-Acute Care, Threatening Access to Care - Center for Medicare Advocacy\" \/>\n<meta property=\"og:description\" content=\"The Medicare Payment Advisory Commission (MedPAC) held a public meeting on September 6, 2018. 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