AHCA Implores Congress to Implement RUG-IV during Lame Duck

WASHINGTON, D.C.—Stating that the 111th Congress was “too close to fail” on two issues critical to the continued delivery of senior care, the American Health Care Association (AHCA) and the Alliance for Quality Nursing Home Care this week urged Congress to fully implement the new Medicare payment system for skilled nursing facilities, in addition to extending the Medicare Part B therapy exceptions process.

“The groundwork for fully implementing the new RUG-IV payment system has been laid,” said AHCA President and CEO Bruce Yarwood in a statement. “There is no cost to this necessary change. We are almost there. Congress is too close to fail on this. So we urge congressional leaders to bring these two measures across the finish line in these final days so we can continue doing what we do best—delivering exceptional care to residents and patients.”

Failure to act, Yarwood argued, would bring about “an operational nightmare for facilities,” and require the Centers for Medicare & Medicaid Services (CMS) to modify the payment system yet again, making payment policies even more uncertain.

In addition, AHCA and the Alliance said Congress must act by December 31 in regard to Medicare Part B therapy exceptions process, or Medicare patients will be limited in the amount of Part B physical, occupational, and speech-language therapies they are allowed to receive.

“For skilled nursing facility patients, the December 31 deadline is critical, since the healthcare reform law only extends the exceptions process until that time,” Yarwood said.