Long-term care providers are finally able to exhale and look forward to enjoying a compromise that would cut down the waiting period before full enforcement of the “75% Rule.” In November, Congressional negotiators changed a provision in the omnibus appropriations act to allow speedier enforcement of the 75% rule, but unrelated disputed provisions in the mammoth bill held up its official passage until Monday.
In the bill’s current form, the Centers for Medicare & Medicaid Services must wait only for the General Accountability Office to complete a study it has already started, plus 60 days for a review period, before enforcement of the 75% rule could begin. Previously, providers were looking at having to wait for a lengthier Institute of Medicine study of the issues before possible implementation.
The “75% Rule” phases in clinical criteria to determine whether rehab patients should receive their treatment at an inpatient rehabilitation facility or a skilled nursing facility. It was put into effect in July but has not been enforced while legislators and the administration negotiated its future.
Long-term care and certain rehab providers see the 75% rule as a possible boon to business; conversely, it could be damaging to more expensive inpatient and/or acute-care providers. The measure could save the Medicare program as much as $370 million per year, according to estimates.