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