Sitting at the Head Table and Leading Change: AMDA’s 2023 Policy Initiatives

During the pandemic, AMDA – The Society for Post-Acute and Long-Term Care Medicine was able to raise its profile attract attention of policymakers other stakeholders. In past year, organization has continued make inroads on a variety issues gain advocacy momentum. At PALTC23’s Saturday general session, Milta Little, DO, CMD, Society’s 2023-2024 president, noted, “We don’t just want seat at table. We chair committees lead discussions.” Alex Bardakh, MPP, CAE, director public policy advocacy, agreed: “Some have said that we’ve been punching above our weight class; but, in fact, this is class.” He added, “If two years taught us anything, it’s we know what will happen, but can control how respond actions take.” did exceptionally well demonstrated tremendous resiliency. busy during year. Its leadership worked successfully avert physician accountable care (ACO) participation pay cuts supported significant increases nursing facility Evaluation Management Codes. same time, 2022–2023 Suzanne Gillespie, MD, RD, an engaged valued participant White House Roundtable COVID-19. On state level, there big action. California legislature passed bill requiring all medical directors be certified. Elsewhere, Massachusetts introduced legislation do same, states are working training requirements disclosure laws. Christian Bergman, State Policy & Advocacy Subcommittee, created work groups focusing registers issues. employing AMDA’s playbook with sample letters, checklists, tools utilize promote change level,” Dr. Bergman said. Perhaps biggest news 2022 introduction H.R. 177, designed amend Title XI Social Security Act ensure facilities report information their directors. Co-sponsored by Representatives Mike Levin (D-CA) Brian Fitzpatrick (R-PA), “requires Centers Medicare Medicaid Services revise regulations so as specifically require skilled identity related information.” Mr. Bardakh said, “I would like urge you go grassroots page [https://paltc.org/advocacy] ask your representatives support this.” This came about partly because hard members — Dan Haimowitz, FACP, Karl Steinberg, HMDC, CMD who led way efforts get books. proof, suggested, value being involved efforts. “You next person responsible permeates affects health care.” addition much horizon addressing. expiration Public Health Emergency May 11, 2023. included three-day stay waiver around certified nurse assistant (CNA) training. CMS look possibility extending continuing started pandemic benefit long-term care. Administration implementation home reform, including proposed rule ownership minimum staffing mandates. Last released position statement mandates, which “AMDA recognizes while having adequate critically important, levels should not become fixed ceiling, based only resident-to-worker ratios or assumptions staff availability easily fixable variable adequately safely address meet resident needs.” (Read full https://bit.ly/3HfNDLN.) Telehealth reimbursement. more permanent flexibilities reimbursement telehealth use, already extended 2024. Victoria Walker, Committee, “There still lot discussion needs happen telehealth. There ongoing discussions payment these services.” She observed it common knowledge useful, doesn’t replace bedside Physician Fee Schedule payments Quality Payment Program. continues physicians paid appropriately services PALTC. Just recently, they expressed provide annual Economic Index updates payments. Snapshot newsletter, observed, “While many concerns system need addressed, great first step toward fixing inequities injecting financial stability into practices, allowing them invest new ways providing ultimately [ensuring] beneficiaries access high-quality Experience coding guidelines. Updates ICD-10-CM code 2023 include 1,176 billable codes areas such social determinants dementia. updated codes, went effect April 1, also seven deletions one revised code. Walker listening learning better different.” Growing focus antipsychotic stewardship. As psychotropic use large proportion schizophrenia diagnoses homes.” agency concerned associated increased prescribing population. While stewardship yet mandated CMS, organizations developing implementing programs help appropriate documentation facilities. Moving Forward. part Forward Nursing Home Coalition. coalition brings together numerous individuals vital changes practice through power diverse voices. addressing person-centered care, culture change, planning; well-trained workforce; transparency accountability finances; financing systems; systems quality assurance, measurement, continuous improvement. thrilled improve quality,” Alice Bonner, PhD, RN, GNP, chairing coalition. Ultimately, creating sustained Timothy Holahan, vice “takes major metropolitan area, village.” “Coming out voice shape policy. unique opportunity, help.” Senior contributor Joanne Kaldy freelance writer New Orleans, LA.