The latest proposed rule from the CMS would increase Medicare payments to more than 1,200 inpatient rehabilitation facilities by about $150 million for fiscal 2008, the agency said Wednesday.
The proposed rule calls for a 3.3% increase in the payment rate, based on the rehabilitation, psychiatric and long-term-care hospital marketbasket. Also, the CMS proposed increasing the high-cost outlier threshold to $7,522, up from $5,534 in fiscal 2007.
Although the higher threshold would mean that fewer cases would qualify for outlier payments, a lower outlier threshold would require an across-the-board reduction in the base payment for an (inpatient rehabilitation facility) stay in order to maintain budget neutrality, the CMS said in a news release. The rule would continue to phase in a 75% compliance thresholdknown as the 75% rulewhich requires that at least 75% of an inpatient rehabilitation facilitys total inpatient population have one of the 13 designated medical conditions for which intensive inpatient rehabilitation services are necessary.
Based on the Deficit Reduction Act of 2005, there is a 60% compliance threshold for the 12-month period that began on July 1, 2006; a 65% threshold for the 12-month period starting July 1, 2007; and full compliance of 75% beginning on and after July 1, 2008. An open-comment period on the proposed rule ends July 2, and a final rule will be issued later this year, the CMS said. -- by Jessica Zigmond