POLICY BRIEFINGS


MedPAC Discusses LTCH Rates, Dual-Eligible Coverage Model and ACOs


During its April meeting, MedPAC staff and commissioners said that long-term care hospitals (LTCHs) are reimbursed at higher rates than acute care hospitals. They said that LTCHs are excluded from the inpatient prospective payment system for acute care hospitals (IPPS) and as a result the current LTCH Prospective Payment System rates are based on inflated costs and distort resource use. The panel considered three different approaches that might be used to equalize LTCH and acute care hospital rates, including an expanded outlier policy, a new Medicare severity diagnosis-related group and bundling post-acute care costs under a new Correct Coding Initiative (CCI) MS-DRG. MedPAC also discussed whether it would be feasible to accommodate Medicare/Medicaid dual-eligibles under a new Medicare system modeled along the lines of Medicare Part D. Concerns were expressed that assigning dual-eligibles, especially those with severe physical and cognitive issues, to the lowest-cost health plan would involve significant year-to-year plan changes from current options. MedPAC members also expressed some concerns regarding how accountable care organizations (ACOs) under the PPACA will assign beneficiaries to providers and compete with Medicare Advantage plans.


Upcoming Health-Related Hearings/Markups


The Senate Finance Committee will hold a hearing on Tuesday, April 9, 2013 at 10:00 a.m. on the nomination of Marilyn Tavenner to be the Administrator of the Centers for Medicare and Medicaid Services. (215 Dirksen Senate Office Building)

The House Energy and Commerce Health Subcommittee will hold a hearing on Tuesday, April 9, 2013 at 4:00 p.m. entitled “Reauthorization of Animal Drug User Fees: ADUFA and AGDUFA.” (2123 Rayburn House Office Building)

The Senate Health, Education, Labor and Pensions Committee will mark up mental health legislation on Wednesday, April 10, 2013 at 10:00 a.m. intended to “help schools become safer and help people struggling with mental health problems to get the treatment that they need.” (430 Dirksen Senate Office Building)

The House Energy and Commerce Health Subcommittee will hold a hearing on Thursday, April 11, 2013 at 10:00 a.m. entitled “Strengthening Medicare for Seniors: Understanding the Challenges of Traditional Medicare’s Benefit Design.” (2322 Rayburn House Office Building)

The Senate Health, Education, Labor and Pension Committee will hold a hearing on Thursday, April 11, 2013 at 10:00 a.m. entitled, “A New, Open Marketplace: The Effect of Guaranteed Issue and New Rating Rules.” (430 Dirksen Senate Office Building)

The Senate Finance Committee will hold a hearing on Thursday, April 11, 2013 at 2:30 p.m. on the President’s Fiscal Year 2014 Budget. (215 Dirksen Senate Office Building)

The House Ways and Means Committee will hold a hearing on Friday, April 12, 2013 at 9:00 a.m. regarding President Obama’s budget proposals for the Department of Health and Human Services for fiscal year 2014. The only witness will be HHS Secretary Sebelius. (1100 Longworth House Office Building)



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