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A federal advisory panel has released a draft recommendation to redefine long-term care hospitals under Medicare. The Medicare Payment Advisory Commission suggested limiting LTCHs’ ability to provide care to patients who can be served more appropriately in acute care hospitals or skilled nursing facilities.

MedPAC said Friday that LTCHs “should be defined by facility and patient criteria that ensures patients are medically complex, have a good chance of recovery, and cannot be treated in less costly settings.” There were 318 LTCHs in 2003, up from 105 a decade earlier.

Commission executive director Mark E. Miller said many of the changes could be made administratively.

The issue is gaining attention because Medicare spending on the sector soared to $1.9 billion in 2001 from $398 million in 1993. Further, CMS estimates spending will reach $2.8 billion this year, according to MedPAC. Medicare pays for 71% of LTCH cases, according to the commission.

The recommendation will be voted on in April. To see the report, go to : www.medpac.gov/public_meetings/index.cfm?meeting_id=103.