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July 15, 2004 01:00 AM

Spending bill contains one-year stay on '75% rule'

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    Hospitals can still hope for a stay on the so-called "75% rehab rule" after the House Appropriations Committee passed by voice vote Wednesday a spending bill for HHS, the departments of Education and Labor, and related agencies. The bill includes an amendment by Reps. Nita Lowey (D-N.Y.) and Zach Wamp (R-Tenn.) that would delay new rules on rehabilitation payments for one year while the Institute of Medicine studies the potential impact on facilities. The new rules, which went into effect July 1, change the qualifying criteria for rehab hospitals and, as such, higher Medicare payments. Under the rules, 75% of a hospital's patients must fall into a defined set of conditions by 2007 for the hospital to receive rehab rates. Providers have complained that many legitimate rehab hospitals will not be able to meet the new criteria.

    The spending bill also has an amendment by Rep. Steny Hoyer (D-Md.) that would bar the CMS from withholding information about Medicare from Congress. A recent report by HHS' inspector general's office concluded that a former CMS administrator did not break criminal law when he pressured the agency's chief actuary into withholding cost estimates for the Medicare reform law. The full House is expected to vote next week on the 2005 spending bill -- which would give HHS $63.2 billion in discretionary funding and $374.3 billion in total funding, with mandatory spending included. The amendments would have to survive both the House and Senate to have a chance at becoming law. -- by Tony Fong

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