PAC Reform


AAPM&R works to ensure that Physiatry’s voice is heard in every aspect of Post-Acute Care (PAC) reform given that physiatrists work in each PAC setting.

At the end of 2014, Congress passed the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. The IMPACT Act intends for standardized PAC data to improve Medicare beneficiary outcomes through shared-decision making, care coordination, and enhanced discharge planning.

AAPM&R’s Principles for AAPM&R Principles for a Medicare Unified Post-Acute Care Payment System are 11 principles that ensure physiatry’s needs are met in any PAC reform. These principles are used to guide AAPM&R advocacy on this issue.

AAPM&R’s advocacy on PAC reform has two main prongs: 

1. Participating on the RTI International Technical Expert Panel (TEP). This TEP works with the Centers for Medicare and Medicaid Services (CMS), which is responsible for drafting a report and creating a prototype on a Unified PAC Prospective Payment System (PPS) to present to Congress, as mandated by the IMPACT Act of 2014.

AAPM&R's Participation on the RTI TEP began in 2018, when the TEP was convened:

2. Advocating to Congress to delay the implementation of the IMPACT Act. The Resetting the IMPACT Act (TRIA) was initially introduced in 2020, prompted by the COVID-19 Public Health Emergency (PHE). This legislation resets the implementation timeline for the IMPACT Act to ensure CMS can incorporate patient and quality data that reflect the impact of COVID-19 and other recent changes to Medicare PAC payment.

AAPM&R’s Legislative Efforts focus on resetting the timeline of the IMPACT Act. AAPM&R’s wins in this space include helping this bill get introduced!

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