Rep. Carol Miller, U.S. Representative for West Virginia 1st District | Official U.S. House headshot
Rep. Carol Miller, U.S. Representative for West Virginia 1st District | Official U.S. House headshot
Washington, D.C. – Congresswoman Carol Miller (R-WV) introduced the Patient Access to Long Term Care Hospitals (LTCH) Care Act, aiming to provide financial stability to the LTCH industry through targeted reforms that ensure adequate reimbursement for high-acuity patients. Representatives Adrian Smith (R-NE), Lloyd Smucker (R-PA), Beth Van Duyne (R-TX), and John Joyce (R-PA) joined her in this initiative.
“Long Term Care Hospitals (LTCHs) provide invaluable care to the sickest patients across the United States. During COVID-19, these hospitals stepped up to ensure patients on ventilator support had the care they need, and they continue to provide care to those that need it most," said Congresswoman Miller. "Providing adequate reimbursement for LTCHs will ensure they have the stability they need to continue serving our most vulnerable populations. I’m glad to introduce the Patient Access to LTCH Care Act to support stability in Medicare reimbursement for LTCHs and ensure patient access to these lifesaving facilities."
Congressman Smith highlighted the importance of flexibility for Critical Access Hospitals (CAHs). “For areas of the country like the Third District with numerous critical access hospitals, permitting CAHs to discharge patients directly to a long-term care hospital is a critical flexibility,” he stated.
"Excessive regulations and rising costs have forced many health care providers to close their doors," noted Congresswoman Van Duyne. "Some of the most endangered facilities are Long Term Care Hospitals which provide extended ICU-level care... Our bill will help LTCHs keep their doors open by ensuring they receive adequate Medicare reimbursements."
Dr. Ed Prettyman, President of National Association of Long Term Hospitals (NALTH), praised the legislation: “The important reforms in this comprehensive legislation would ensure Long Term Care Hospitals are more accurately reimbursed for caring for our most critically ill seniors... NALTH urges Congress to swiftly consider and pass this important legislation.”
Ellen Kugler from the Coalition of Long-Term Acute-Care Hospitals also expressed gratitude: “LTCHs fill a vital role in the health care continuum... The Patient Access to LTCH Care Act will allow LTCHs to care for the very sickest patients, improve access in rural areas, and ensure intensive care availability nationwide.”
The Patient Access to LTCH Care Act includes several provisions:
- Caps FY25 and FY26 high-cost outlier fixed cost amount at $50,000.
- Limits future year-over-year fixed loss amount increases.
- Increases reimbursement by 5% or 10% based on patient complications or comorbidities.
- Extends LTCH PPS rate coverage for specific severe conditions including COVID-19.
- Allows discharges from CAHs directly into an LTCH.
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