Medicare Package Includes Important Rehabilitation Provisions

Medicare Package Includes Important Rehabilitation Provisions

Posted By Scarlett Law Group || 4-Jan-2008

Congress approved a Medicare "extenders" bill this week, which includes three significant rehabilitation provisions that have been legislative priorities this year for BIAA: Medicare's 75 Percent Rule on inpatient rehabilitation, Medicare outpatient therapy caps, and the pending regulation on Medicaid's Rehabilitation Services Option.Although the primary focus of the bill was to avert a 10 percent Medicare physician payment cut in 2008, the final version of this "bare bones" Medicare package addressed these three important rehabilitation priorities which impact many individuals with brain injury.

BIAA has been actively working all year long, as a Member of the Coalition to Preserve Rehabilitation (CPR), to advance these priorities, and appreciates the grassroots work of many advocates who participated in recent BIAA targeted Action Alerts to urge legislators to include these three provisions in this Medicare package.

Below is a summary of the bill as it pertains to each of these priorities:

Medicare's 75 Percent Rule: In a major victory for rehabilitation advocates, the bill will permanently freeze implementation of the 75 Percent Rule at the 60 Percent level, as well as allow comorbid conditions to continue to count toward meeting the rule's threshold. Additionally, the bill requires that HHS study beneficiary access to inpatient rehabilitation services and makes recommendations for classifying inpatient rehabilitation hospitals and units. These changes will effectively increase access to inpatient rehabilitation when appropriate for individuals with disabilities, including those with brain injury.

Medicare's Outpatient Therapy Caps: The bill will extend the current exceptions process for Medicare's cap on outpatient rehabilitation therapy services through June 30, 2008. While this is not the long-term fix CPR Members had advocated for this year, it does allow continued access to outpatient rehabilitation therapy for individuals who need it most - including many individuals with brain injury - and Congress is likely to address this issue again before this extension expires in six months.

Medicaid Rehabilitative Services Option
: The bill places a six-month moratorium on issuance of final regulations to restrict allowable services under the Medicaid Rehabilitative Services Option. Again, while this is not the longer-term moratorium CPR members had promoted, it does allow advocates additional time to work with Congress to prevent final implementation of this harmful regulation, which, if implemented, could restrict access to rehabilitative services important to many individuals with brain injury.

As there are still several unresolved Medicare inpatient rehabilitation issues, and the therapy cap exceptions extension and the moratorium on the Medicaid regulations expire in six months, BIAA looks forward to continuing its work as a Member of CPR next year in advancing these important rehabilitation priorities.

Source: BIAA

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