Skilled nursing providers and inpatient rehab facilities offer clashing views on Medicare payments

A bill from Reps. Andy Barr (R-KY) and Ami Bera (D-CA) would create a safe harbor system to reduce malpractice lawsuits against Medicare and Medicaid providers, and it would give providers the right to request state-level suits move to federal court.

Under the “Saving Lives, Saving Costs Act,” professional associations would create clinical practice guidelines that could be invoked if a malpractice lawsuit is filed. An eligible professional who is being sued could argue that he or she adhered to the relevant practice guidelines, which would cause a suspension in the proceedings while an independent medical review panel investigates.

If the panel determines that the defendant conformed to the guidelines, or that the failure to conform was neither the cause or “proximate cause” of the alleged injury, the case would be dismissed pending “clear and convincing evidence” that the medical review panel was in error.

The clinical practice guidelines would be drawn up by professional organizations. These could potentially include groups such as the American Geriatrics Society and AMDA-Dedicated to Long-Term Care, Barr’s office confirmed to McKnight’s. The bill describes potential standards for the guidelines and a schedule for reviewing and updating them.

Long-term care providers would be included in the bill’s right of removal provision, Barr’s office also confirmed. This states that “any healthcare liability action brought in a state court” against an eligible provider can be transferred by the defendant to the applicable U.S. District Court.

An official announcement of the bill is scheduled for today, a Barr spokeswoman told McKnight’s. The full text of the legislation will be available here.