In a letter to the editor published March 3 by KFF Health News, Jim Prister, president and CEO of RML Specialty Hospital and chair of the AHA Post-Acute Steering Committee, urged Congress to address chronic underpayments and insurance barriers that are harming patient care and access to long-term care hospitals. Prister highlighted the importance of LTCHs and how they offer highly personalized care to individuals recovering from a catastrophic illness or injury, and he detailed changes by Congress to reimbursement and other issues that have negatively impacted LTCHs. “Furthermore, insurance company barriers — such as prior authorization requirements put in place by Medicare Advantage plans — are creating harmful delays and denials of necessary and time-sensitive patient care,” Prister wrote. “Consequently, many patients are denied access to an LTCH setting — or transferred to other post-acute care settings like rehabilitation or skilled nursing facilities that aren’t equipped to care for patients with highly complex needs like ventilation.” 

Headline
The Centers for Medicare & Medicaid Services April 10 released a proposed rule that would establish electronic standards for drug prior authorizations.…
Perspective
Public
Few patient populations are more vulnerable to the shifting winds around health care today than Medicare beneficiaries who need specialized, high-acuity and…
Headline
A group of hospital stakeholders, including the AHA, the Federation of American Hospitals, the National Association of Long Term Hospitals and the Coalition of…
Headline
A KFF survey published today found that people view prior authorization as the biggest challenge beyond costs when navigating the health care system. In terms…
Headline
The Centers for Medicare & Medicaid Services Dec. 2 repealed the minimum staffing requirements for nursing homes that participate in Medicare and Medicaid…
Headline
A Health Affairs study published Nov. 3 examined an increase in states banning prior authorizations in private insurance plans for opioid use disorder…