House Passes Legislation that Delays LTCHs 25 Percent Rule

NASL, 10/7/2016 -

On September 21, 2016, the House of Representatives passed H.R. 5713, the Sustaining Healthcare Integrity and Fair Treatment (SHIFT) Act of 2016.

Congressman Patrick Tiberi (R-OH), chairman of the House Ways and Means Subcommittee on Health, introduced H.R. 5713, the SHIFT Act on July 11, 2016. The SHIFT Act provides regulatory relief to all Long-Term Care Hospitals (LTCHs) from the “25 percent rule.” The CMS rule, which has been delayed for ten years, allows for no more than 25 percent of patients to come from one inpatient acute care hospital in one quarter. The legislation reinstates the 50 percent threshold that was in effect prior to July 1, 2016, and delays the rule for nine months (October 1, 2016 through June 30, 2017).

The SHIFT Act will also provide targeted relief from the site neutral payment policy enacted as part of the Bipartisan Budget Act of 2013 for four specific LTCH groups.  The first group is any new LTCH that has come into the Medicare program since December 26, 2013.  The second group is any LTCH that was in existence prior to September 3, 1982 and was exempt from the prospective payment system established in the Tax Equity and Fiscal Responsibility Act of 1982.  The third group is any LTCH that primarily treats Medicare patients who have severe spinal cord injuries.  The fourth group is any LTCH that was in existence after September 3, 1982 and before September 30, 1995 and is a small LTCH within another hospital.

The Senate would also need to take action on the SHIFT Act prior to adjournment for the 114th Congress.