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At ABCS RCM, we have been following a few Congressional acts. The election of President Trump and the debate over the ACA (Obamacare) has occupied most of the headlines. However, the passing of the 21st Century Cures Act by the federal government in late 2016 was a significate event.

The bill was signed into law on December 13, 2016 by President Obama and had previously cleared the Senate with a 94 to 5 vote and the House with a 392 to 26 House vote. However, the Act was not without critics.

Some politicians argued that the new law creates negative changes to the drug approval processes that gave too many concessions to pharmaceutical companies.

The purpose of the Cures Act is to accelerate the “discovery, development and delivery” of medical therapies by encouraging biomedical research investment. The act is also intended to encourage increase medical innovation while facilitating a better “review and approval process” for experimental healthcare products and procedures.

The massive bill also serves as a vehicle for a variety of other health-related measures. The new law allocates $4.8 billion in new funding for the National Institutes of Health; of that, $1.8 billion is reserved for the “cancer moonshot” in order to accelerate research in that field. Another $1.6 billion is earmarked for brain diseases including Alzheimer’s.

Also included are $500 million in new funding for the Food and Drug Administration (FDA) and $1 billion in grants to help states deal with opioid abuse.

The new law also provides changes to the regulations surrounding long-term care hospitals.

Changes for Long-Term Care Hospitals:

The new 21st Century Cures law also provides some relief for long-term care hospitals (LTCHs) under a one-year moratorium on the “25 percent rule,” which would otherwise penalize LTCHs that admit more than 25 percent of their patients from a particular acute care hospital. Under the new law, implementation of the 25 percent rule will be suspended during federal fiscal year 2017 (October 1, 2016, through September 30, 2017).

The new legislation also establishes a number of other new policies and technical changes to existing LTCH statutes, but most of the changes will affect only limited subsets of LTCHs with special circumstances.

The new law provides an exception to the current moratorium on new LTCH beds to allow for an expansion in the number of LTCH beds at satellite locations of existing LTCHs, so long as the satellite expansion project was in place as of April 1, 2014.

Other changes for LTCHs in Cures Act include modifying the calculation methodology for high-cost outlier payments to LTCHs; removing less favorable length-of-stay provisions for determining when to apply certain site-neutral payment policies that are applicable to hospitals that converted to LTCHs after December 1, 2013.

There is also a reclassification of certain LTCHs focusing on cancer care to provide for cost-based reimbursement for such hospitals. Finally, there is a temporary suspending of site-neutral payment policies for LTCHs specializing in spinal cord injuries and certain discharges related to severe wound care.

For more information about the 21st Century Cures Law: Congress passes 21st Century Cures Act.

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LTCH Legal updates, 21st Century Cures Act, Long-Term Care Hospitals, ACA