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Washington, D.C. – December 19, 2014: The Center for Medicare Advocacy, and the rest of the Coalition to Preserve Rehabilitation (CPR), an alliance of leading national consumer and clinician organizations, expressed disappointment over the recommendation approved today by the Medicare Payment Advisory Commission (MedPAC) to recommend “site-neutral” payment for certain Medicare patients in need of medical rehabilitation following injury or illness. The coalition believes this policy will inappropriately divert patients who need inpatient hospital rehabilitation to less intensive settings such as nursing homes based on their diagnosis, not based on their individual clinical needs.

"MedPAC made the wrong decision today to achieve cost savings at the expense of vulnerable Medicare beneficiaries who may be denied the intensive and coordinated rehabilitation care they need. Clinicians should determine when a patient needs hospital-level rehabilitation, not financial incentives that essentially bar the door to the appropriate setting of care," stated Susan H. Connors, president and CEO of the Brain Injury Association of America, and CPR member. "MedPAC’s site-neutral payment policy is based on a false premise. Inpatient rehabilitation hospitals and nursing homes are far from equivalent. They have different regulatory requirements, levels of care coordination and intensity, and achieve different clinical outcomes."

In a letter sent last week to MedPAC, CPR opposed MedPAC’s proposal on site-neutrality and raised concerns about the lack of transparency in the Commission’s decision to support this policy. These concerns and recommendations were not meaningfully addressed by the Commission before the MedPAC vote.

"As a beneficiary organization, the lack of transparency makes you wonder who, and what kind of Medicare program, MedPAC is intended to serve," said Judith Stein, executive director of the Center for Medicare Advocacy, and CPR member. "MedPAC’s website would not accept our written comments all week and our witness was cut off after only two minutes during the public comment session. Most troubling, however, is the MedPAC commissioners endorsed a proposal that pretends two very different levels of care are the same, and failed to specify which patients will be impacted by their new policy."

It will now be up to Congress whether to adopt MedPAC’s site-neutral payment recommendation.

"We plan to work with other patient, consumer and clinician organizations to make sure Congress understands the risk patients will face if payments are equalized between inpatient rehabilitation hospitals and nursing homes for certain conditions," said Alexandra Bennewith, vice president government relations, United Spinal Association. "When going to the Hill next year, we’ll educate lawmakers about how patients in inpatient rehabilitation hospitals with a variety of conditions have better outcomes, go home earlier and live longer than similar patients treated in nursing homes."

Contact: Judith Stein, 860-456-7790 or

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