House bill would change qualifying criteria of therapy’s 75% Rule

A new bill introduced in the House would erode criteria in the 75% Rule that puts skilled nursing facilities at an advantage over other facilities.

The bill – a companion to a Senate bill – would lower the threshold to qualify as an in-patient rehabilitation facility. Only 50% of admissions would have to meet one of 13 conditions for the facility to qualify for inpatient rehab status and consequently receive more Medicare funding. SNFs, whose admissions often have multiple conditions, more easily qualify as IRFs. 

Introduced by Rep. Frank LoBiondo (R-NJ), the bill matches the Senate bill sponsored last week by Jon Corzine (D-NJ), Ben Nelson (D-NE) and Rick Santorum (R-PA). As of July 1, facilities needed 60% of admissions to meet the criteria, under the current 75% Rule. That would rise to 75% in July of 2007.