AHCA's Yarwood: 'We're going to have to fight'

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While 2006 has been a good year for providers, threats loom in the post-election horizon. Providers should brace for difficult political, regulatory and legal battles in 2007, according to the leader of American's largest nursing home organization.

Regardless of what happens in the November elections, providers will be targeted for funding cuts and unwelcome regulatory changes, warned Bruce Yarwood, president and CEO of the 11,000 member American Health Care Association. He spoke at the organization's annual convention in San Antonio. Should the GOP keep control of both Congressional chambers, funding cuts to key domestic programs are likely. A split chamber or a Democratic takeover likely will shift the change-making venue to regulatory agencies, he noted.

"We're looking at a future that says we're going to have to fight," Yarwood predicted. Among the most likely trouble spots: therapy caps rules, changes to Medicare payments, Medicaid provider taxes and new compliance standards. For example, the Centers for Medicare & Medicaid Services has already begun using State Operations Manuals to essentially revise regulations, he said.

Yarwood added that the association has a "war chest" and enough member support to challenge what he considers unfair practices, whether by lawsuits or other legal channels. The organization is also willing to openly identify and criticize public officials who act in ways that undermine providers, he noted.

Such defiant statements would have been unlikely a year ago, when the association found itself reeling from leadership challenges and internal sniping. AHCA Chairman Angelo Rotella said that by streamlining the organization and giving individual states a louder voice, the AHCA has become stronger and more resilient. Moreover, increasing demand and relatively strong reimbursement levels have helped put many AHCA members on sounder fiscal footing.