tci Medicare Compliance & Reimbursement - 2003 Issue 33

Rehab: RELIEF IN SIGHT ON 75-PERCENT RULE

How does a 65-percent rule sound?Struggling inpatient rehabilitation facilities may be able to qualify for the IRF prospective payment system after all. After an outcry from IRFs on what it takes to be eligible to receive payments under the IRF PPS - industry groups maintained that the strict criteria outlined in the Centers for Medicare & Medicaid Services' 75-percent rule could rule out virtually every IRF in the country- CMS is proposing some changes. As it stands now, the 75-percent rule requires IRFs to demonstrate that 75 percent of its inpatient population requires intensive rehab services for at...

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