AHA raises concerns with prototype PAC payment model

Aug 24, 2021 - 12:50 PM
AHA-OIG-letter

AHA today raised “substantial concerns” with the prototype payment model that the Centers for Medicare & Medicaid Services, Department of Health and Human Services Assistant Secretary for Planning and Evaluation, and RTI International are developing for the new unified post-acute care prospective payment system required by the Improving Medicare Post-Acute Care Transformation Act of 2014.

“In particular, we are not confident that the eventual prototype will be capable of yielding accurate payments for the full array of patients treated across the four PAC settings,” AHA wrote, imploring CMS, ASPE and RTI to address its questions, issues and concerns at the next meeting of the RTI Technical Expert Panel. 

The letter enumerates multiple gaps in the methodology used thus far to build the new PAC payment prototype. 

“If some portion of these design challenges is found to be insurmountable, or cannot be adequately mitigated, our current ask of Congress to reconsider and refine the IMPACT Act timeline related to PAC PPS development would become even more urgent,” AHA said.
 

Related News Articles

Headline
Senate reaches deal to potentially end government shutdown this week
The Senate Nov. 9 took a critical first step toward ending the government shutdown as seven Democrats and Sen. Angus King, I-Maine, joined Republicans to…
Headline
CMS launches payment model for state Medicaid programs to purchase drugs at most-favored-nation pricing
The Centers for Medicare & Medicaid Services is launching a new initiative for state Medicaid programs to purchase prescription drugs at prices aligned…
Headline
AHA comments on CY 2026 physician fee schedule final rule 
The AHA commented Nov. 3 on the Centers for Medicare & Medicaid Services’ calendar year 2026 final rule for the physician fee schedule. The rule, released…
Headline
CMS issues CY 2026 physician fee schedule final rule
The Centers for Medicare & Medicaid Services Oct. 31 released its calendar year 2026 final rule for the physician fee schedule. As required by law,…
Headline
Shutdown likely to continue into fifth week
There is still no clear end in sight to the government shutdown as today marks day 30 and is approaching the 35-day record that occurred in 2018-2019. Some…
Chairperson's File
Chair File: Inside the Shutdown and Other Key 2025 Priorities
Public
This week brings the fourth week of the federal government shutdown as Congress has yet to pass legislation to fund the government. This shutdown is a bit…