After months of pressure from providers, legislators tried last week to force the CMS to back off new regulatory requirements for rehabilitation providers that went into effect this month.
The effort came in the form of an amendment tacked onto the appropriations bill approved last week by the House Appropriations Committee. That bill earmarks $63.2 billion in discretionary funds for HHS in fiscal 2005.
The bill could go to the House floor this week, although one Democratic staffer suggested Republican leaders might delay the vote until September. The Senate has not yet considered its own version of the spending bill.
The amendment would put into place a one-year moratorium on the so-called "75% rehab rule," which went into effect this month. The regulation requires that 50% of a hospital's patients have at least one of 13 conditions for the facility to qualify for rehabilitation rates (July 5, p. 12). Over the next three years that figure is scheduled to rise incrementally until it reaches 75% in 2007. The amendment was sponsored by Reps. Nita Lowey (D-N.Y.) and Zach Wamp (R-Tenn.).
"Our hospitals are struggling to comply with a rule that reflects treatment options in 1984, not 2004," Lowey said in a news release. "If this rule is not updated to reflect today's practices, it will put our local rehab facilities on life support."
Anne Ubl, vice president of legislative affairs at the American Hospital Association, expressed cautious optimism that the amendment would pass the House as part of the appropriations package.
"It has widespread bipartisan support," she said.
The AHA and other provider groups have vehemently complained that many hospitals would not qualify for the rehabilitation reimbursements under the new rules. According to a survey released last week by the AHA and the American Medical Rehabilitation Providers Association, 40% of respondents said they will be forced to turn away rehabilitation patients when the regulations are fully implemented. During the first year of enforcement, 25% of facilities would not meet the new standards. By 2007, that figure would jump to 80%.
"We need to get rid of these draconian regulations," said Felice Loverso, chairman of the board at AMRPA and president and chief executive officer of 64-bed Casa Colina Centers for Rehabilitation in Pomona, Calif.
The broader appropriations bill would give HHS a total of $374.3 billion in mandatory and discretionary funding-$14 billion more than it received in fiscal 2004.