75% rule has cut inpatient rehab admissions: study

Tightened restrictions in the 75% rule have resulted in 30,000 fewer Medicare patients receiving care in inpatient rehabilitation facilities, according to a report released jointly today by the Federation of American Hospitals and the American Hospital Association, both of which list rehabilitation owners and operators among their members. The rule, which went into effect in May, requires that to qualify as a rehabilitation facility and receive higher Medicare reimbursement, a facility must show by 2007 — when the rule will be fully implemented — that 75% of its patients have one of 13 conditions. Yesterday, the Consortium for Citizens with Disabilities, a coalition of 33 national disability organizations, sent a letter to House leaders stating that the CMS’ current interpretation of the rule “threatens the availability” of rehabilitation services. Herb Kuhn, director for the CMS’ Center for Medicare Management, said the rule “is doing what it’s intended to do; removing the risk from the Medicare program for overpayment of these services.” The study, prepared by the Moran Co., was based on benchmarking data from inpatient rehabilitation facilities. — by Matthew DoBias

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