Hern Asks Healthcare Witnesses To Outline Common ‘Unnecessary Delays’ In Providing Post-Acute Care

yesterday

During a House Ways and Means Committee hearing held before the congressional recess, Rep. Kevin Hern (R-OK) questioned healthcare witnesses about delays in providing healthcare.

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Transcript

00:00Mr. Hearn, you're recognized. Thank you, Chairman. I really appreciate you doing

00:04this today, holding this meeting, and I appreciate all the witnesses being here

00:07as well. Post-acute care is the integral part of the health care system. It's

00:11where patients have the chance to really heal and get back home to resume their

00:16daily lives. One piece of the system is long-term care hospitals, also known as

00:20LTACs. LTACs are where the sickest patients go, as you all know, spending an

00:25average of about 26 days there. There are two LTACs in my district back in

00:29Oklahoma, not in the whole state of Oklahoma, and I'm concerned about the

00:33rate of closures we've been seeing in the LTAC industry in the past few years.

00:37While I applaud the work of Congress and what they did in 2013 to address

00:41overpayments and misaligned incentives in the LTAC system, we are now a decade

00:46out, and it's time to look how we can modernize and improve the work that was

00:50done. That's why, alongside my colleague across the aisle, Representative Boyle,

00:55introduced H.R. 1924, the Securing Access to Care for Seniors in Critical

01:00Condition Act of 2025. This bill ensures the sickest of patients are getting the

01:05care they need without unnecessary delays, and that LTACs are getting paid

01:10the appropriate amount for these patients by helping clarify what

01:13constitutes an LTAC payment. The goal of this legislation is to get patients the

01:18setting of care they need when we know they need it.

01:22This is Graybar. Thanks, first of all, for being back. I'm sure you're

01:27happy to be back in this room, at least for a moment anyway, so thank you for all

01:31your work over the past, and the former chairman. I know you have a lot of

01:34experience in this space, and can you tell us what Congress can do to

01:39ensure we get patients to the correct place of care, whether it be an LTAC, an

01:45IRF, or SNF, you got to love the names, or any other place of care they need, as

01:49quickly as we can get their healing process started, and what are some of the

01:54unnecessary delays we are seeing in getting these patients to where they

01:57need to go? Thank you for the question, Mr. Hearn, and congratulations on the bill

02:04that you introduced just last week for regulatory relief for long-term care

02:07hospitals. A bipartisan bill, I might add. Yes, a very nice achievement, and it's a

02:13classic example of what I would classify as regulatory relief, the same type of

02:17policies I'm talking about that would be essential to pair with a unified

02:21post-acute care prospective payment system, so I do think those things could

02:25go together very nicely, and I think specifically long-term care hospitals

02:31could thrive under a revised payment system, so I encourage you to think

02:35about that type of reform and pairing that with the wonderful bill that you

02:38introduced last week. Thank you much, Mr. D'Angeli. I appreciate all the

02:42suggestions for improving the LTAC payment system, and that's why I've

02:46introduced my bill to provide a small bit of certainty for the industry.

02:49However, I want to ask you about the current statutory provision that

02:54specifically grandfathers just a few LTACs from some of changes that have

02:58happened over the last few decades, and do you believe that we should address

03:02these grandfather provisions as we look to modernize LTAC payments? My

03:10understanding of the grandfathered hospitals, they have shrunk. I think

03:13there's eight or less maybe in the country right now. Those LTACs are not

03:19exempt from these payment requirements or the criteria for admission into the

03:26LTAC. They really center on the hospital-within-hospital provisions about

03:33common ownership and common control, so I don't think dealing with that would have

03:39any impact on allowing greater access into the long-term care hospital. One

03:44thing that I do think would allow greater access into the long-term

03:48hospital is dealing with this Medicare Advantage issue. I don't use this

03:52patient example. We have two patients that look exactly alike, both on

03:57ventilators, both have stayed in an ICU for three days. One has Medicare

04:03Advantage, one has traditional fee-for-service Medicare. Our staff go in

04:07and evaluate those patients. The fee-for-service Medicare patient, we can

04:11bring right in, no delay, because they meet the criteria that has been set by

04:16CMS, by Congress. The Medicare Advantage patient, we need to get prior

04:22authorization. We need to go through, they're usually denied because they say

04:27they can receive care in the short-term acute care hospital. They go through an

04:31appeal process. Now, you might say that impacts us, but think about that family,

04:36and we have often had this input coming from family members. They visit with each

04:41other. They're in the rooms right across from each other, and one will say, how

04:45come that patient can go to Madonna, but my family member can't? What's because

04:50you have a Medicare Advantage plan, and they're delaying your admission, and

04:53they're denying it. So, I think that is the key crux of what could happen

04:57short-term to address this problem. Thank you, and obviously, pre-authorization is a

05:03whole other subject for another day, and I really appreciate your thoughts on that.

05:06Thank you so much. I yield back.

Hern Asks Healthcare Witnesses To Outline Common ‘Unnecessary Delays’ In Providing Post-Acute Care

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