The Medicare Payment Advisory Commission said the Centers for Medicare & Medicaid Services proposed regulations on long-term acute-care hospitals are risky.

CMS, in what is dubbed the 25% rule, proposed that LTAC hospitals that operate under larger hospital systems not be allowed to get more than 25% of their admissions from the host hospital.

MedPAC said the rule has serious faults because it does not ensure patients receive the best care and it does not apply to free standing facilities. Such a regulation, MedPAC contends, will simply encourage companies to construct free-standing LTACs instead of hospitals within hospitals.

A group of House and Senate representatives agreed the rule “could potentially negatively impact a physician’s ability to make decisions about which patients need to be transferred from the general hospital to the ‘hospital-in-hospital’ for more serious care.”

Medicare spent $1.9 billion on LTACs in 2001, up from $398 million in 1993.  The comment period for the regulation ended Monday. The proposed regulations become final Oct. 1.