Medicare Compliance & Reimbursement

IRFs will shut down unless CMS acts, rehab hospitals argue.  Inpatient rehabilitation facilities are in for financial challenges that could force as many as a quarter of them to shut down if the Centers for Medicare & Medicaid Services doesn't back down from a controversial component of the IRF prospective payment system. So say the American Hospital Association and the American Medical Rehabilitation Providers Association, citing the results of a survey conducted this month. The rule under fire - dubbed the 75-percent rule - requires rehab hospitals to show that at least three-quarters of their inpatient population over the most recent 12-month cost reporting period required "intensive rehabilitation services for 10 serious medical conditions," such as stroke, amputations and brain injuries. The rule goes into effect Jan. 1, 2004. While the rule has a phase-in period, the AHA and AMRPA survey suggests that the toll will be huge for rehab hospitals. Among the findings: 23 percent of surveyed facilities said they'd have to close if the rule goes into effect as written and more than half would have to cut staff and reduce services. Both AHA and AMRPA are lobbying to have the rule changed. Lesson Learned: Whether IRFs will get relief on the 75-percent rule remains to be seen.