Medicare payments to inpatient rehabilitation facilities would rise 3.2% in fiscal 2008 under a set of final regulations issued by the CMS.
The CMS today said it would not revise its policy on the 75% rule under a final rule that sets payments for inpatient rehabilitation facilities in fiscal 2008. The rule would pay inpatient rehabilitation facilities $6.4 billion in the coming fiscal year, an increase of 3.2%, based on the rehabilitation, psychiatric and long-term-care hospital marketbasket.
The 75% rule represents the minimum percentage of a hospitals patients that must have one of 13 medical conditions requiring intensive inpatient rehabilitation, in order to qualify for higher reimbursement. The rule has been issued in phases, jumping from 60% to 65% this month, and will increase to 75% in July 2008.
The hospital lobby has argued that the 75% level would put a stranglehold on access to care. However, in the final inpatient rehabilitation facilities rule, the CMS indicated that data analysis and clinical research do not support revising the current policy.
Also in July 2008, co-morbidities, or secondary conditions, can no longer be used to determine whether a provider meets the requirements of the 75% rule. Currently, a patients co-morbidities may be used to determine whether a provider met the requirements of the rule, along with a patients principal diagnosis. In other provisions, the final rule updates the inpatient rehabilitation facilities prospective payment wage index, and increases the high-cost outlier threshold to $7,362 in fiscal 2008, up 33% from $5,534 in fiscal 2007.
In another rule issued today, the CMS increases payments to skilled-nursing facilities by 3.3%, or $690 million, in fiscal 2008. -- by Jennifer Lubell
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