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Written by: Mediware on Monday, April 1, 2013 Posted in: Inpatient Rehab

Each year, regulatory ‘junkies’ like myself look forward to the spring AMRPA meeting because their sessions are geared to prepare facilities to meet with legislators to discuss and influence judgements through testimony related to their level of service and how they see proposed mandates affecting access to care and reimbursement. Invited guests have firsthand knowledge of everything we need to be concerned about in today’s ever-changing regulatory white water policy creation.

Of course this could not be done without a host of speakers and this year we were privileged to meet the Hon. Willis (Bill) Gradison, MedPAC Commissioner and Scholar in Residence, Duke Fuqua School of Business, who provided us a glimpse of how MedPAC came to be and the importance of reviewing the latest published report.

He stated, “After prospective payment was put into place in the early 1980s, a series of issues arose. We were concerned that we weren’t getting the true professional advice from HCFA (now CMS), at the time. We needed outside object views that were not just concerned with the budget only. The Prospective Payment Advisory Committee was born. At that time there was a Physician Payment Review Commission and the two were combined to create what is now known as MedPAC.”

He jokingly stated, with minor paraphrasing by me, that each year the panel of experts “prepare reports for every level of service and provide insight and recommendations; often gathering dust and at times rule makers take the information off the shelf to incorporate into law.” He then went on to discuss some items that were ‘off the record’ because they were his personal insights and recommendations. What I found most appealing was his sincere message that the information shared through MedPAC is insightful but requires response from the clinicians at large. Willis states they do not often get feedback after the report is released except from large professional organizations. He truly believes that if a larger audience of those that could be affected by the policy recommendations provided input and testimony that it would have more influence on the decisions policy makers made.

He then announced the completed Report to the Congress Medicare Payment Policy, March 2013 had been available since March. He encouraged everyone to visit its pages and to review and share thoughts on the statements and facts gathered. The recommendations made by the commission are at the end of the report and they urge congress to review the report and recommendations, as well as to reach out for additional information needed to make policy decisions.

I believe many of you will want to read the various chapters dedicated to the lines of service you may work under or manage as well as the discussion on solutions to the sustainable growth rate (SGR) fix. Analyze the rationale offered for the various statements made and see if you agree or feel additional considerations or information should be considered and then make known as an individual or as part of a organization or group you affiliate with in your professional career.


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