AMRPA Access


AMRPA-Supported, The Resetting the IMPACT Act of 2021, Formally Introduced

By AMRPA Headquarters posted 04-27-2021 12:40


By Remy Kerr, MPH, AMRPA Health Policy and Research Manager

On April 12, Representatives Terri Sewell (D-AL-07) and Vern Buchanan (R-FL-16) reintroduced The Resetting the IMPACT Act of 2021 (H.R. 2455) in the US House of Representatives. This bipartisan legislation is endorsed by AMRPA and would delay the data collection and related development of an IMPACT Act-mandated unified post-acute care (PAC) payment system prototype. The delay would be in effect until a period of time after the termination of the COVID-19 public health emergency (PHE) declaration to ensure differences and changes related to the PHE are better accounted for and to ease demands on all PAC providers in the PHE aftermath. Introduction of this legislation was a top policy priority for AMRPA, including during the Virtual Congressional Fly-In last month, and the association has advocated for such a reset on numerous occasions over the last several months.[1] Shortly after its introduction in the 117th Congress, AMRPA submitted a letter of support to the sponsors. As of today’s post, there is not a companion bill in the Senate.

Even before the COVID-19 pandemic, AMRPA had several concerns related to the IMPACT Act timeline, such as its failure to fully account for major payment system changes to all four PAC settings since being signed into law. In addition, several standardized patient assessment data elements, such as those related to social determinants of health, have yet to be implemented by CMS into the inpatient rehabilitation facility, long-term care hospital, skilled nursing facility, and home health Quality Reporting Programs as mandated under the IMPACT Act. AMRPA believes such data elements are critical for development of any payment model, and the COVID-19 PHE has only intensified those concerns.  

Lastly, AMRPA believes that the major policy changes impacting all PAC providers (and the COVID-19 PHE) since IMPACT Act passage warrant a broader reconsideration of the unified PAC model concept, and that stakeholder-driven reform may be the better path forward. Therefore, AMRPA supports H.R. 2455 as an important first step in ensuring that IMPACT Act implementation reflects the current realities of the PAC continuum.

AMRPA staff and counsel will continue to engage with Congressional offices to garner support of the bill and promote its advancement. We encourage AMRPA members to stay tuned for potential grassroots advocacy opportunities in the coming months. If you have any questions on the bill, contact AMRPA Government Relations and Policy staff.

[1] AMRPA Recommendations Regarding Pandemic Preparedness Legislation,

  AMRPA Response to the COVID-19 Interim Final Rule,

  AMRPA Letter to Congressional Leadership re: Resetting the IMPACT Act Timeline,

  AMRPA Letter to CMS/RTI Technical Expert Panel on a Unified Post-Acute Care Prospective Payment System