CMS Announces Rule That Would Lower Payments To Inpatient Rehabilitation Facilities

Main Category: Rehabilitation / Physical Therapy
Also Included In: Primary Care / General Practice;  Medicare / Medicaid / SCHIP
Article Date: 23 Apr 2008 - 8:00 PST

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A rule released by CMS on Monday would reduce funding for inpatient rehabilitation facilities by about $20 million in fiscal year 2009, CQ HealthBeat reports. The reduction is required by legislation that Congress approved last year to prevent a scheduled cut to Medicare physician payments and reauthorize SCHIP through March 2009. CMS expects to spend about $5.6 billion in FY 2009 and about $30 billion over the next five years on the more than 1,200 IRFs in the U.S. The facilities -- which treat people who have had serious illnesses and injuries, such as stroke or spinal cord injuries -- receive higher payments than other facilities because the patients require more intensive and coordinated rehabilitation therapy services.

The proposed rule also would freeze at 60% the proportion of patients that must fall into certain medical categories in order for the facilities to qualify for IRF payments, according to CQ HealthBeat. The proportion was scheduled to increase to 75%, but hospitals had said the increase would affect access to inpatient rehabilitation for Medicare beneficiaries. Acting CMS Administrator Kerry Weems said the proposed rule also includes several measures to improve the accuracy of payments to the facilities.

The public comment period on the rule ends on June 20. CMS will publish a final rule by Aug. 1 (Carey, CQ Health Beat, 4/21).

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