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Improving Medicare Post–Acute Care Transformation Act (IMPACT Act)​

Categories: Medicare, Social Security

The Improving Medicare Post-Acute Care Transformation Act of 2014 (HR 4994), commonly called the IMPACT Act, was signed by President Barack Obama as Public Law 113-185 on October 6, 2014. The legislation was designed to create a standardized platform to assess the efficacy of the treatment methods, quality measures, and health outcomes achieved by post-acute care (PAC) providers. The PAC providers covered by the Act include home health agencies (HHA), skilled nursing facilities (SNF), inpatient rehabilitation facilities (IRF) and long-term care hospitals (LTCH).

The IMPACT Act amends Title XVIII of the Social Security Act (SSA) to add a new section (Sec. 1899B) that requires PAC providers to report standardized patient assessment data, quality measures, and resource use measures.

The law requires the Secretary of the U.S. Department of Health and Human Services to modify PAC assessment instruments to allow for submission of standardized patient assessment data and to allow for comparison of such data across all such providers. The Act identifies the tools to be used for such comparisons as well as the applicable reporting provisions and the applicable PAC payment systems.

The law requires PAC providers to report the initial standardized patient assessment data by October 1, 2018, for SNF, IRF and LTCH providers and January 1, 2019, for HHAs. The standardized patient assessment data includes functional status, cognitive function, special services, medical condition, impairments, prior functioning levels and any other categories as identified by the Secretary to be necessary and appropriate.

The Act authorizes the Secretary to specify additional quality measures that PAC providers are required to submit. The measure shall include the following quality domains: functional status and changes in function, skin integrity and changes in skin integrity, medication reconciliation, incidence of major falls and patient preference regarding treatment and discharge options.

The Act also requires the Secretary to provide confidential feedback to the PAC provides on their performance with respect to all quality measures and resource use measures under applicable reporting provisions.

The Act requires the Medicare Payment Advisory Commission (MedPAC) to submit reports to Congress on a PAC payment system that sets payment rates according to individual characteristics rather than the setting where the patient is treated.

The Act authorized $200 million from the Federal Hospital Insurance Trust Fund to pay for the law.

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