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

Some House lawmakers raised concerns last week over the Medicare Payment Advisory Commission’s plan to recommend reimbursement cuts for post-acute care providers to Congress.

MedPAC executive director Mark Miller, Ph.D., told the House Ways and Means Health Subcommittee that the recommendation to freeze payment updates to skilled nursing facilities for fiscal year 2018 will leave providers with “adequate” payments. It would not hurt beneficiaries or their access to care, he said.

Miller also noted the post-acute care payment system should ideally operate under a unified payment system, and “the cost of inaction is mounting.”

“The cost to the program of not implementing the Commission’s recommendations is substantial,” Miller said in his testimony. “Medicare is paying more for services than it needs to.”

Lawmakers pushed back MedPAC’s recommendations, voicing concerns that the healthcare providers they represent could suffer under the proposed cuts.

Rep. Pete Roskam (R-IL) said the “crown jewel” inpatient rehabilitation facility in his district could lose 20 cents per dollar under the proposals, Modern Healthcare reported. Rep. Adrian Smith (R-NE) argued that supplemental Medicare payments are vital for ambulance providers in his district that serve rural areas.

Despite resistance from some lawmakers who represent providers who would take a financial hit under MedPAC’s recommendations, others echoed Miller’s remarks that the program is in need of improvement.

“Meeting with Medicare providers around my district and state, a resounding concern that I have heard is that overbearing regulations are increasingly burdening providers and seem to be driving out and discouraging small providers,” said Subcommittee Chairman Pat Tiberi (R-OH). “I’m worried about the direction we’re heading.”