‘75% Rule’ Affected Rehabilitation Care for 30,000 Medicare Beneficiaries, Study Says

About 30,000 fewer Medicare beneficiaries received care in inpatient rehabilitation facilities in the first year of implementation of the "75% rule," which determines whether hospitals qualify as IRFs and receive higher reimbursement rates, according to a study released on Thursday by the American Hospital Association and the Federation of American Hospitals, CQ HealthBeat reports. According to the report, CMS has underestimated the number of Medicare beneficiaries that the rule will affect, and the number likely will increase as the agency continues to phase in the regulation. "The rule makes it harder for patients to get the care they need," AHA Executive Vice President Rick Pollack said, adding, "It puts government bureaucracy in the middle of important decisions best left to patients and their physicians." FAH President Chip Kahn added that the study indicates "the rule is having a far greater impact on patients than originally projected." The groups have asked Congress to pass legislation (S 1405 and HR 3373) that would extend the period in which CMS will phase in the rule to allow time for more research on the potential effects. However, Herb Kuhn, director of the CMS Center for Medicare Management, said that the rule has worked as expected. He added, "Nobody's being denied care. What's happening is that people are going to other settings for care" that are more appropriate (CQ HealthBeat, 9/22).