[{"_1":2,"_111":-5,"_112":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75,87,99],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":72,"_74":72},"mediaId",6282661,"mediaKeyId","2593307-5feffd77581b0929f5de5d0fb929f0d0","parentId",2593307,"title","Home‑health and Hospice Leaders Urge Payment Fixes, Wider Use of Telehealth to Preserve Rural Access","audioSeconds",4237,"startMs",2458000,"endMs",6695000,"viewUrl","/Search/View?dp=1&key=2593307-5feffd77581b0929f5de5d0fb929f0d0&start=2458&end=6695","thumbnailUrl","https://assets.pipeline.soar.com/2593307-5feffd77581b0929f5de5d0fb929f0d0/thumbnail_2458000.jpg","articleUrl","/articles/6282661/Homehealth-and-Hospice-Leaders-Urge-Payment-Fixes-Wider-Use-of-Telehealth-to-Preserve-Rural-Access","mediaUrl","https://secure.pipeline.soar.com/6282661-93b73601ed0819c0d313e3ab3566d208/orig.mp4?Expires=1771098373&Signature=MPZ-BRh3Ia2wMhW3MTU66aGGxB-XdWrre9foMb47R2dvFXCSi9DlFCAmuxd47hFtbaxKbIGPF0DkbHoCxFaiav8e3geJpczmj3iW0aQGYw7-NHKklLj2F8xBn0tbFglLL4V1wcYh8xra2m31L4zX~AqTioC499LOoYftGJuS1uSBxSZN3MjYUTt31USswEm0XO7nKRGv-EPYtghqG9O7e0vgzq6US6dtH3pCt36gIWbHZsLHkH4gpILOpucA4RWbBsApAoMToMOaRAt53Te5s5w42iC~Eqb7fxxuwBRdm1qrJH0b8zL2vQTmcpugzKlqTkQeKwoSyJrOD4vhZXb1JA__&Key-Pair-Id=KUT5TJCACFTXG","author","U.S. House Committee on Ways & Means","date","2025-03-12T09:36:24Z","article","WASHINGTON — Executives representing home‑health and hospice providers told the House Ways and Means Health Subcommittee that payment cuts, administrative complexity and Medicare Advantage practices are straining the sector and reducing access, especially in rural areas.

Dana Madison, an administrator of family‑owned home‑health agencies in West Texas, described decades of payment changes and regulatory shifts that have compressed rural agency margins. She recounted the transition from cost‑based reimbursement to interim payment systems, the 2020 prospective payment and then the PDGM model, and said rural add‑on payments were phased out in 2022. Madison said many staff travel hundreds of miles per week for rural visits and urged Congress to make telehealth and remote monitoring fully reimbursable.

\"Most senior citizens in America want to receive care in their home,\" Madison said. She told the panel that home‑health care is cost‑effective and that telehealth reimbursement and workforce supports are needed to preserve access.

Jonathan Pleece (testifying as the president and CEO of Empath Health) urged stronger support for hospice, saying hospice reduces hospitalizations and preserves patient choice. Pleece and other witnesses described pressures including thin margins, excessive audits and uneven enforcement that penalize providers while some bad actors evade oversight.

Witnesses and members discussed hospice recertification flexibility legislation introduced by Congresswoman Carol Miller that would allow telehealth for hospice recertification visits; Madison and others expressed support for telehealth flexibility that they said would help rural patients and caregivers. Several members also discussed workforce development, remote patient monitoring, and occupational therapy scope changes as ways to streamline discharges and improve post‑acute transitions.

Panelists asked Congress to consider pay‑for‑performance adjustments, better Medicare Advantage oversight for prior‑authorization and reimbursement parity for remote care. No final votes were taken; witnesses offered to provide technical follow‑up and data to the committee.","mediaType","Video","parentTitle","Health Subcommittee Hearing on After the Hospital: Ensuring Access to Quality Post-Acute Care","oneSentenceSummary","Home‑health and hospice executives told lawmakers that recent reimbursement cuts, administrative burdens and rising Medicare Advantage enrollment threaten home‑based care; witnesses urged telehealth expansion and performance‑based payment adjustments.","taxTitle","Ways and Means: House Committee, Standing Committees - House & Senate, Congressional Hearings Compilation, Legislative, Federal","taxId",1828,"location","","headline","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":72,"_73":72,"_74":72},6282666,"Long‑term Acute Care Hospitals Cite Prior Authorization, Payment Rules for Shrinking Access",91,2803000,2894000,"/Search/View?dp=1&key=2593307-5feffd77581b0929f5de5d0fb929f0d0&start=2803&end=2894","https://assets.pipeline.soar.com/2593307-5feffd77581b0929f5de5d0fb929f0d0/thumbnail_2803000.jpg","/articles/6282666/Longterm-Acute-Care-Hospitals-Cite-Prior-Authorization-Payment-Rules-for-Shrinking-Access","https://secure.pipeline.soar.com/6282666-891a0bfc9171ceeb8d9d47114b906584/orig.mp4?Expires=1771098373&Signature=CGoaUoe2goUeOgqlxr1FCvG~PmjhXVBnKSnhFzOAS1BmB8GO5Ph5hzwvAnV7SdnobuyE8j3LGFR1J~Z7-ocmr~7iVKiI69ohhHK2xFfXuu6P6KW6tXNWG31A~wKwD8IpRTf6oXlTZFrg6JIRcVeyE~1sUjewhKBC1Jh~jr6zTpytXgYUY0-dleN~C72NgCh1mGn-km9dvhQOb2U3Voo9tlAU-ZKrhsEZmxf3aXrgZMFtcjO4JCabukh4ATNAXNIV94i~cRCCyyJk~WOwVc~RLuBMinHqsT1-u4CKhPYZtDGLF9m2-bVOS8RC8ZVrCtpsjjPvMiy4NrJfawsWXJx7LA__&Key-Pair-Id=KUT5TJCACFTXG","WASHINGTON — Leaders of long‑term acute care hospitals told the House Ways and Means Health Subcommittee that recent payment changes and Medicare Advantage prior‑authorization practices have reduced patient access to specialized post‑acute care and contributed to industry shrinkage.

Paul Donghilly, president and CEO of Madonna Rehabilitation Hospitals, described how the high‑cost outlier fixed‑loss threshold for LTACs doubled between fiscal year 2023 and fiscal year 2025, raising the amount a facility must lose before receiving an extra payment from about $38,000 to roughly $77,000. Donghilly said the change has pushed some LTACs from modest margins into negative territory and discouraged admission of high‑cost patients.

\"When an individual is on a ventilator and requires additional high‑cost services, losing $77,000 before receiving an outlier payment ... would deter that LTAC from admitting them,\" Donghilly testified.

Donghilly and other witnesses also testified that Medicare Advantage plans deny a large share of prior‑authorization requests for LTAC and inpatient rehabilitation facility admissions, triggering time‑consuming appeals that delay transfers. He said that in practice, two clinically similar patients — one in fee‑for‑service Medicare, one in Medicare Advantage — can have substantially different access because MA plans often require prior authorization and deny requests more frequently.

Members from both parties raised bills to address access concerns. Representative Hearn noted bipartisan legislation introduced as the Patient Access to Long Term Care Hospitals Act and other bills intended to clarify LTAC payment policies and expand admission pathways, such as permitting direct admission from critical access hospitals. Witnesses urged Congress to consider legislative fixes to the outlier methodology, to allow direct admissions from small hospitals, and to strengthen enforcement of MA rules.

Witnesses warned that unless payment policy and MA practices change, LTAC closures will continue and access to specialized services — including ventilatory, dialysis and other high‑resource care — will be limited. The subcommittee did not take a vote; members may submit follow‑up questions for the record.","Long‑term acute care hospitals (LTACs) told the House Ways and Means Health Subcommittee that tightened payment rules and Medicare Advantage prior‑authorization practices have reduced access and contributed to LTAC closures.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":92,"_47":93,"_49":94,"_51":95,"_53":96,"_55":56,"_57":58,"_59":97,"_61":62,"_63":64,"_65":98,"_67":68,"_69":70,"_71":72,"_73":72,"_74":72},6282670,"Advocates and Members Urge Retention of CMS Minimum Nursing‑home Staffing Standards",858,3938000,4796000,"/Search/View?dp=1&key=2593307-5feffd77581b0929f5de5d0fb929f0d0&start=3938&end=4796","https://assets.pipeline.soar.com/2593307-5feffd77581b0929f5de5d0fb929f0d0/thumbnail_3938000.jpg","/articles/6282670/Advocates-and-Members-Urge-Retention-of-CMS-Minimum-Nursinghome-Staffing-Standards","https://secure.pipeline.soar.com/6282670-17feff25a019b6bfd065c9adfa1e5a2a/orig.mp4?Expires=1771098373&Signature=J8SEI8NEyHqFdGJTQY1XGiyG8ZK3~tetgOtQPksF4lkK87qPsF5fBtk0PQ3chiErFAj4oVjj64h8MKzM5FOTnKldU54Ad43j1L3InaH~XgjReN-TDsXar86nN5xrHE6zTS~tNxQJ7vrcSwVQWBfiqK92~jPzlTWcjOymzoKqrqAfjln-Na5MxfR4RRLKKb-kqcI75tWxNzuFVYplTw549BZ~JyAbH0M0mTjGWf4gHfx5Iq6ZvSx-m9vG6Xc~OfEFKM6WAf~3lGtuRB1bysy-vaXnw~xnZTwxbAqpTLhe7LPynsWG9DGcPO6IkwS9D1M-nNHNrOKfLqtbOpdnC5Ayow__&Key-Pair-Id=KUT5TJCACFTXG","WASHINGTON — At a March hearing on post‑acute care, advocates and some lawmakers urged the House Ways and Means Health Subcommittee to preserve new federal nursing‑facility staffing requirements, saying the rules would improve resident outcomes and save lives.

\"These standards require a registered nurse around the clock,\" Eric Carlson of Justice in Aging told the subcommittee. He summarized the final CMS rule as requiring at least 3.3 hours of direct care per resident per day, including about 2.5 hours from nurse aides, and a registered nurse on site 24 hours a day.

Carlson and other witnesses cited research estimating the rule could prevent thousands of deaths annually. \"Researchers at the University of Pennsylvania estimate a savings of 13,000 lives annually,\" Carlson said. Witnesses added that staffing requirements include phase‑in periods and hardship exemptions for rural providers facing genuine labor shortages.

Republican members questioned the rule's practicability in rural areas and warned of facility closures if staffing cannot be found. In response, Carlson emphasized both the phase‑in timeline and hardship exemptions and noted the rule is targeted to address historically inadequate staffing levels and associated harms such as bed sores, falls and infections.

Members asked witnesses about workforce constraints and retention strategies. Witnesses and some members recommended improving wages, working conditions, and investment in recruitment and training rather than rolling back the federal standard.

No legislative action was taken during the hearing. Witnesses urged the committee to balance regulatory relief with measures to preserve resident safety while considering workforce supports and implementation timelines.","Witnesses told the House Ways and Means Health Subcommittee that CMS’s 24/7 registered nurse and minimum direct‑care hour standards should be implemented to improve resident outcomes and reduce preventable harm.",{"_33":100,"_35":36,"_37":38,"_39":101,"_41":102,"_43":103,"_45":104,"_47":105,"_49":106,"_51":107,"_53":108,"_55":56,"_57":58,"_59":109,"_61":62,"_63":64,"_65":110,"_67":68,"_69":70,"_71":72,"_73":72,"_74":72},6282675,"Members Warn $880 Billion in Proposed Medicaid Cuts Would Threaten Post‑acute Care Access",7679,1947000,9626000,"/Search/View?dp=1&key=2593307-5feffd77581b0929f5de5d0fb929f0d0&start=1947&end=9626","https://assets.pipeline.soar.com/2593307-5feffd77581b0929f5de5d0fb929f0d0/thumbnail_1947000.jpg","/articles/6282675/Members-Warn-880-Billion-in-Proposed-Medicaid-Cuts-Would-Threaten-Postacute-Care-Access","https://secure.pipeline.soar.com/6282675-e1cfb8f825798d8db0170db9bffaa948/orig.mp4?Expires=1771098373&Signature=aTMq0RQb~kThe4y6M4Uq7GSoTbzzba73j~26GmI65ZKtVwSfQOQflxVGgeiLPRZwUy-4-uYxY1zqecEIF~Auq4pEfWyIkzt-T5PBw3-FdE5pApa-1p315uRNibVB~JCjUcCesBqzuEiLw0B5keB0fkaotdKNeDvUL0gpr3XLcaNlOD4lq34S~8-F7zzzJ0~-2fzJGMrt05fJSB02PSVv-TyATyEVsNHJDq59cdgX8hKHyI3MTcGeUnnhiWX6nH3Fw7UXv3m2E03j6E7RxV3dNL3Febp2sbWeR7B4X8h6hIdzbBWmwX5YUevKpKFzKI-sItjZXEy5nj8h3ovWsWWJ4w__&Key-Pair-Id=KUT5TJCACFTXG","WASHINGTON — Members of the House Ways and Means Subcommittee on Health and witnesses at a March hearing warned that Republican budget plans calling for $880 billion in cuts to Medicaid would undermine access to post‑acute care for seniors and people with disabilities.

\"I don't believe you can talk about access to post acute care in America today without talking about Medicaid. It is the primary payer for this care,\" said Representative Lloyd Doggett, the subcommittee's ranking member, in his opening statement. He added that the budget plan would force many families to choose between crippling medical debt and loss of care.

Witnesses from advocacy groups and providers described Medicaid as the primary funding source for long‑term services and supports and said deep cuts would force states to scale back home‑ and community‑based services, nursing facility coverage and payments that support workers and providers. Eric Carlson, director of long‑term services and supports advocacy at Justice in Aging, told the panel that many older Americans rely on Medicaid for services Medicare does not cover and that proposed reductions would be “devastating for the people that rely upon it.”

Members on both sides cited local impacts. Representative Thompson warned that Medicaid reductions could force closures of rural long‑term care facilities, cost local jobs, and increase drive times for emergency care. Representative Chu described constituent stories of individuals who depend on Medicaid to pay for hip and spine surgery follow‑up and long‑term supports.

Subcommittee members and witnesses repeatedly stressed that Medicare alone does not cover long‑term daily supports and that Medicaid often pays Medicare cost‑sharing for low‑income beneficiaries. \"Medicaid is the only thing that's available for them,\" Carlson said, summarizing the witnesses' testimony on how the programs interact.

The hearing included calls for congressional oversight and policy alternatives to preserve Medicaid's structure and funding. Several members urged maintaining or increasing funding for home‑ and community‑based services and workforce supports rather than making cuts that would fall heavily on vulnerable populations.

The subcommittee did not vote on any measure during the hearing. Members were allowed to submit additional questions for the record, and witnesses said they would continue to work with lawmakers on legislative options to protect access to post‑acute and long‑term care.","House subcommittee witnesses and members told the House Ways and Means Health Subcommittee that plans to cut $880 billion from Medicaid would sharply reduce access to post‑acute care, jeopardizing long‑term services for seniors and people with disabilities.","actionData","errors"]

Article not found

Home‑health and Hospice Leaders Urge Payment Fixes, Wider Use of Telehealth to Preserve Rural Access

Long‑term Acute Care Hospitals Cite Prior Authorization, Payment Rules for Shrinking Access

Advocates and Members Urge Retention of CMS Minimum Nursing‑home Staffing Standards

Members Warn $880 Billion in Proposed Medicaid Cuts Would Threaten Post‑acute Care Access