Can't edit my other comment but also wanted to note that they added the clawback provision, which is a common tactic. What this does is allows them to add any type of payment scheme they want, and they can decide later if it was abused. So, if medical professionals are prescribing a drug with no medical value, they can decide that was fraud later and recoup the funds. It may be 5 or 10 years later but they often do this type of thing, hospitals are aware of that risk, and it would be rather cavalier/criminal to significantly abuse it for financial gain. It could even result in criminal charges, lost medical licenses, etc.

It’s hard to tell but these things have been rolled out quick with a broad approach of; don’t give any hospital any reason not to admit a sick patient during the pandemic. Normally a patient in outlier territory would have a hard time finding a long term acute care location if they were likely to lose the LTAC money. So they quickly instituted various add on and kicker “bonuses” such that nearly no patient would loss the LTAC money.

LTAC companies, in capitalism, would simply not accept patients if they thought they were too sick to make money on. Accepting parients put them out of business. The government wants hospitals to admit as many patients as they can in a health crisis. So , I feel this was more of a case where they acted quick and broad and didn’t actual think much about whether the drug was valid. If doctors want to prescribe it, it shouldn’t bankrupt the hospital where they work. The clinical value is up to the medical professions to figure out.