In a letter to the editor published March 3 by KFF Health News, Jim Prister, president and CEO of RML Specialty Hospital and chair of the AHA Post-Acute Steering Committee, urged Congress to address chronic underpayments and insurance barriers that are harming patient care and access to long-term care hospitals. Prister highlighted the importance of LTCHs and how they offer highly personalized care to individuals recovering from a catastrophic illness or injury, and he detailed changes by Congress to reimbursement and other issues that have negatively impacted LTCHs. “Furthermore, insurance company barriers — such as prior authorization requirements put in place by Medicare Advantage plans — are creating harmful delays and denials of necessary and time-sensitive patient care,” Prister wrote. “Consequently, many patients are denied access to an LTCH setting — or transferred to other post-acute care settings like rehabilitation or skilled nursing facilities that aren’t equipped to care for patients with highly complex needs like ventilation.” 

Headline
A KFF survey published today found that people view prior authorization as the biggest challenge beyond costs when navigating the health care system. In terms…
Headline
The Centers for Medicare & Medicaid Services Dec. 2 repealed the minimum staffing requirements for nursing homes that participate in Medicare and Medicaid…
Headline
A Health Affairs study published Nov. 3 examined an increase in states banning prior authorizations in private insurance plans for opioid use disorder…
Headline
The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address…
Headline
The AHA Sept. 29 sent recommendations to the Department of Health and Human Services and the Centers for Medicare & Medicaid Services to help ensure…
Headline
The Centers for Medicare & Medicaid Services Innovation Center Aug. 12 released an FAQ on the Wasteful and Inappropriate Service Reduction Model, a six-…