Report: '75% rule' having intended effect

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Federal healthcare officials say the so-called "75% rule" is producing intended effects on therapy services. That should be good news for many long-term care providers, who stand to benefit from the regulation's enforcement.

There have been 30,000 fewer Medicare patients receiving therapy services in inpatient rehabilitation facilities since the rule went into effect in May, according to a study commissioned by two major hospital associations. They say the study results mean that fewer Medicare beneficiaries are receiving, or have access to, needed services.

Federal health officials, however, believe that -- much to the delight of nursing home advocates – beneficiaries are simply using skilled nursing facilities more often, which are cheaper for the Medicare program to reimburse. Nursing homes are more likely to meet the 75% rule's stipulation that three-quarters of a facility's patients have at least one of 13 qualifying conditions.

The rule "is doing what it's intended to do -- removing the risk from the Medicare program for overpayment of these services," said Herb Kuhn, director for the Centers for Medicare & Medicaid Services' Center for Medicare Management.

The study was prepared by the Moran Co., based on benchmarking data from inpatient rehabilitation facilities. For more information, visit the American Hospital Association's Web site at http://www.aha.org.