CMS to make it official: Medicare therapy criteria to change

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CMS to make it official: Medicare therapy criteria to change
CMS to make it official: Medicare therapy criteria to change
Federal officials are now taking comments on a proposal that would implement the "60% Rule," which indirectly would decrease the flow of rehab patients to long-term care facilities.

The rule is scheduled for publication in Friday's Federal Register. The comment period for it closes June 20; the Centers for Medicare & Medicaid Services is expected to issue a final rule by Aug. 1.

While long-term care providers might envy inpatient rehabilitation facilities (IRFs) for winning the battle to serve more rehab patients, the government proposal also would cut payments to the nation's 1,200 IRFs by $20 million in fiscal 2009.

The rule mandates that the portion of patients that must fall into certain treatment categories will be 60% for a facility to get extra funding. The floor previously was 65% and was set to rise to 75% by summer 2009, which would have pushed more patients out of IRFs and into long-term care rehab facilities.

CMS Acting Administrator Kerry Weems said the proposals, which included other payment adjustments and were formally announced Monday, would "help to ensure that these services continue to be available to those who need them, while helping to preserve the Medicare Hospital Trust Fund for future generations."