2017 Regulatory Trends for Skilled Nursing Facilities and Rehab Providers

by Rita Cole, SLP, Clinical Director at Optima Healthcare Solutions

Several regulatory issues and trends that have an impact on the health care industry, specifically on Skilled Nursing Facilities (SNFs) and rehabilitation providers, are currently in the spotlight on Capitol Hill. Though these regulations will have a direct impact on SNFs, therapy providers will also be affected, so it’s important for all therapy providers to be aware of the implications.

Major Regulatory Trends to Follow in 2017  

Most of the current regulatory trends are longstanding issues that are being intensified by the present political climate, including the introduction of the American Health Care Act (AHCA). More changes are likely to occur, but below is a summary of the major trends you should be aware of.

Healthcare Overhaul: President Trump campaigned on a promise to “repeal and replace” the Affordable Care Act (ACA), which he initiated by introducing the AHCA. That effort has slowed since the bill was pulled from the House floor on March 24, but House Republicans remain committed to seeing it through. On April 6, Congressman Gary Palmer and Congressman David Schweikert proposed an amendment to the AHCA that provided ideas for lowering premiums for health insurance coverage.  Reportedly, negotiations continue. The House will be voting on ACA legislation in the coming months, so the AHCA may have an impact on SNFs after all.

Access to Care: Patient access to care was among the largest criticisms to the AHCA, but it has been a cause of concern for quite some time. This concern first arose when Congress introduced the Medicare outpatient rehabilitation therapy cap under the Balanced Budget Act of 1997, which imposes a cap and an exceptions process for physical therapy, occupational therapy and speech-language pathology services. On February 1, 2017, Senator Benjamin Cardin introduced the Medicare Access to Rehabilitation Services Act of 2017, the goal of which is to safeguard access to care for at-risk Medicare beneficiary groups. A repeal of the cap has garnered bipartisan support, as well as support from industry associations, including APTA.

Payment Reform: Therapy services have been under scrutiny for several years. Several payment reform initiatives have been introduced including the reformulation of reimbursement for treatment mode minutes, concurrent therapy and group therapy, the implementation of COTs and the implementation of PUF reports. Over the past year, both CMS and the Medicare Payment Advisory Commission (MedPAC) have made reference to alternative payment system initiatives. The industry is currently awaiting the Proposed Rule for Skilled Nursing Facilities, as well as this year’s annual MedPAC report. Thus, the impact on therapy providers regarding payment reform initiatives remains to be seen.

Regulatory education on the go

Since regulatory trends can change quickly, therapy providers need access to the latest information in a format that can be easily shared with colleagues and staff.

At Optima, we’re committed to providing you with the information you need to plan for your business. Recently, we created a white paper outlining the regulations you need to be aware of in 2017 -- click here to download the free white paper, Therapy in the Trump Era.