AGS Endorses Alzheimer’s Research Bill
AGS has endorsed legislation introduced in both the House and the Senate that would double federal spending for research on Alzheimer’s disease. “The Ronald Reagan Alzheimer’s Breakthrough Act” (S.2533/H.R.4595) would increase the amount allocated to the National Institute on Aging for Alzheimer’s research from $680 million to $1.4 billion in FY 2005. The bill “recognizes the important need to focus more attention on finding a cure for Alzheimer’s disease while simultaneously educating the public about important prevention techniques,” AGS said in a letter to Senate bill sponsors Barbara Mikulski (D-MD) and Christopher Bond (R-MO). S.2533/ H.R. 4595 puts three existing Alzheimer’s research programs at the NIA into statute: prevention research, cooperative clinical research, and caregiving research.

The legislation also would provide a $3000 annual tax credit for family caregivers of Alzheimer’s patients and establish a tax deduction for premiums on long-term care insurance. It seeks to increase access to respite care services through grants to states and non-profit organizations.

CMS Pilot Program to Test Background Checks on Long-Term Care Workers
Underway at CMS is a pilot program to evaluate comprehensive background checks for new workers in long-term care facilities. Aimed at combating abuse and neglect of residents, the initiative was mandated by the Medicare Modernization Act (MMA), which set aside $25 million to fund pilots that will operate in up to 10 states through the end of fiscal year 2007.

The pilot programs will help identify “best practices” for long-term care providers to determine whether a job seeker has any kind of criminal history or other disqualifying background that could make them unsuitable to work directly with patients, CMS said in a release. Long-term care facilities and providers in participating states will include nursing homes, home health agencies, hospices, long-term care hospitals, intermediate care facilities for persons with mental retardation, and other entities that provide long-term care services.

The background check for each prospective employee will include a check of state registries, such as the Nurse Aide Registry, as well as a search of state and criminal history records.

States may use the money to implement a comprehensive background check program, or to improve upon an existing program.Ê At least one state must also include patient abuse prevention training for managers and employees of long-term care facilities and providers as part of their program. CMS plans to select the pilot participants this fall.

Skilled Nursing Facility Payments to Rise by 2.8%
Medicare payment rates for skilled nursing facilities (SNFs) will rise by 2.8% beginning October 1, 2004. CMS estimates that the FY 2005 fee schedule will increase provider payments by $440 million.

“We are committed to providing high-quality care to those in nursing facilities and to paying nursing homes properly for that care,” said Mark B. McClellan, MD, PhD, administrator of CMS. “Therefore, in conjunction with implementing higher nursing home payments, CMS is also taking further steps to improve nursing home quality including enhancements in enforcement and oversight activities. In addition, CMS is also strengthening its publicly reported information on nursing home quality.”

Under Medicare’s skilled nursing facility prospective payment system (SNF PPS), each facility is paid a daily rate based on the relative needs of individual Medicare patients, adjusted for local labor costs. The daily rate covers the costs of furnishing all covered nursing facility services, including routine services such as room, board, nursing services, and some medical supplies; related costs such as therapies, drugs and lab services; and capital costs including land, buildings and equipment.

In FY 2005 CMS said it will retain temporary add-on payments for SNFs pending the results of a study due in January.

For a copy of the Federal Register notice, go to http://www.access.gpo.gov/su_docs/fedreg/a040730c.html and look under the Centers for Medicare and Medicaid Services.

Inpatient Rehabilitation Facilities Get Boost in Payment Rates
Also beginning October 1, inpatient rehabilitation facilities (IRFs) are slated to receive a 3.1% increase in their payment rates.  Overall IRF payments for FY 2005 are projected at $5.7 billion, up from a projected 5.4 billion in FY 2004, according to CMS.

Under the notice, payment rates for rural facilities will jump by 19% to offset their higher costs, CMS said. The agency estimates there will be about 483,000 Medicare admissions to Medicare-certified IRFs in FY 2005.

In related news, the House of Representatives in September voted to halt implementation of a controversial CMS policy known as the “75% rule” until a study is completed of its impact on rehabilitation services. To qualify for the higher payments provided to IRFs, Medicare has historically required that at least 75% of the facility’s population had to have one of 10 diagnoses generally associated with the need for intensive inpatient rehabilitation. Critics of the policy argue that it unduly restricts access to rehabilitative care and is based on outdated criteria. Final action on the moratorium, included as an amendment to the FY 2005 Department of Health and Human Services appropriations bill, was pending at press time.