The Centers for Medicare and Medicaid Services (CMS) on April 21 proposed a rule that will improve the accuracy of payment for services furnished to people with Medicare who need the intensive rehabilitation services provided by inpatient rehabilitation facilities (IRFs). CMS is proposing to apply a zero percent increase factor for IRF payment rates for FY09. As a result, CMS expects to spend roughly $5.6 billion in FY09 and approximately $30 billion in the next five years for IRF services.
The proposals are intended to improve the accuracy of Medicare payments for these services by recalculating the rates using more recent information from rehabilitation hospitals about the costs they have incurred in treating patients. The proposal would implement policies for FY09 requiring that 60 percent of a facility’s patient population have one of 13 specified qualifying conditions and allowing facilities to count patients whose principal reason for needing inpatient rehabilitation services is not one of the specified conditions, but whose treatment is complicated by the presence of one of the 13 conditions as a secondary diagnosis.
Comments on the proposed rule are due by June 20, 2008; the final rule will be published on or before Aug. 1, 2008. Download the proposed rule.
