On July 13, 2016, the House Ways and Means Committee approved an amended version of H.R. 5713, the “Sustaining Healthcare Integrity and Fair Treatment Act of 2016” or “SHIFT Act.” The primary focus of the SHIFT Act is to delay further the full implementation of the “25 Percent Rule” for long-term acute care hospitals (“LTCHs”).  Under the 25 Percent Rule, an LTCH is allowed to admit up to 25% of its patients from a single general acute care hospital; for patients admitted past the 25% threshold, an LTCH faces a significant Medicare reimbursement reduction.

Under current law, the Centers for Medicare & Medicaid Services (“CMS”) has been precluded from fully implementing the 25 Percent Rule for freestanding LTCHs for cost reporting years beginning before July 1, 2016, and for LTCH hospitals-within-hospitals (“HIHs”) for cost reporting years beginning before October 1, 2016. The SHIFT Act would prohibit full implementation of the 25 Percent Rule for nine months for both freestanding LTCHs and LTCH HIHs for discharges occurring on or after October 1, 2016 through June 30, 2017.  (However, it would also allow the 25 Percent Rule to go into effect for LTCH HIHs for cost reporting years beginning on or after July 1, 2016 rather than October 1, 2016, thereby creating a gap period before the nine month prohibition would begin.)
Continue Reading Ways and Means Approves Bill to Delay LTCH 25% Rule Implementation, Make Other LTCH Reforms