On April 27, 2009 Congressmen Earl Pomeroy (D-ND), John Larson (D-CT), Lloyd
Doggett (D-TX), and John Yarmuth (D-KY) introduced H.R. 2124, also known as the
Medicare Long-Term Care Hospital Improvement Act of 2009. The Bill,
if enacted, would amend the the Medicare, Medicaid, and SCHIP Extension Act of
2007 (MMSEA) by extending its term for an additional two year period through
December 28, 2012. The MMSEA provided long-term acute care hospitals (LTACHs)
with important payment and regulatory relief from unfavorable patient transfer
rules (e.g., the “25% Rule”). The MMSEA also established a temporary three-year
moratorium on the development of new freestanding LTACHs, new satellite
facilities, and bed increases from December 29, 2007 to December 28, 2010. The
development moratorium would likewise be extended.
In addition to ensuring regulatory stability, extending the MMSEA would give
both the Secretary of Health and Human Services, and a project co-sponsored by
the Acute Long Term Hospital Association (ALTHA) and National Association of
Long Term Hospitals (NALTH) additional time to develop facility and patient
criteria for LTACHs.
The Bill’s extension of the MMSEA’s development moratorium would produce
savings for the Medicare program, and an additional cost saving offset provision
in the Bill would provide for annual budget neutrality between rate years 2011
and 2015. The budget neutrality offset amount, which would be limited annually
to 1.5%, would be deducted from the annually adjusted Long-Term Care Hospital
Prospective Payment System base rate.
The Bill is supported by ALTHA, the American Hospital Association, the
Federation of American Hospitals and NALTH. Congressman Larson, one of the
Bill’s sponsors, spoke in favor of the Bill at NALTH’s Annual Conference on
April 30, 2009 and commented that the sponsors hoped to see it pass by the end
of the summer. Sponsors and industry representatives expect a similar bill to be
introduced in the Senate in May.
Please contact one of the authors below or a member of McGuireWoods’
Long-Term Care team
for additional information.