Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

Rehab Hospital Care

CMS Revises Inpatient Rehabilitation Facility “Review Choice Demonstration” – Confirming Individual Assessments Must be Used to Adjudicate Claims

The Steering Committee of the Coalition to Preserve Rehabilitation (“CPR”), a coalition of 57 organizations that advocate for policies to ensure access to rehabilitative care so that individuals can regain and/or maintain the maximum level of health … [Read more...] about CMS Revises Inpatient Rehabilitation Facility “Review Choice Demonstration” – Confirming Individual Assessments Must be Used to Adjudicate Claims

Patients Need Therapy – Medicare Payment Systems Create Barriers

A unified Medicare payment system that pays all institutional post-acute care providers the same rates, regardless of setting, runs counter to repeated analysis showing that all post-acute providers are not the same, even when they treat patients … [Read more...] about Patients Need Therapy – Medicare Payment Systems Create Barriers

New Fact Sheet Available – Medicare Inpatient Rehabilitation Hospital/Facility Coverage In Light of Jimmo v. Sebelius

With support from the John A. Hartford Foundation, the Center for Medicare Advocacy has produced a new Fact Sheet to help Medicare beneficiaries and their families respond to unfair Medicare denials for care at inpatient rehabilitation … [Read more...] about New Fact Sheet Available – Medicare Inpatient Rehabilitation Hospital/Facility Coverage In Light of Jimmo v. Sebelius

CMS Clarifies 3-Hour “Rule” Should Not Preclude Medicare-Covered Inpatient Rehabilitation Hospital Care

Inpatient rehabilitation hospitals (IRHs, also known as Inpatient Rehab Facilities/IRFs) provide intensive rehabilitation services to patients on an inpatient basis.[1]  Over time, a myth developed – based on a discredited CMS Policy … [Read more...] about CMS Clarifies 3-Hour “Rule” Should Not Preclude Medicare-Covered Inpatient Rehabilitation Hospital Care

Saga of an Inpatient Hospital Appeal: Notice and Use of Lifetime Reserve Days and Comments on Observation Status

This CMA Alert highlights a recent individual ALJ decision that sets out an important but often unrecognized beneficiary right to a written notice when he or she is about to use hospital “Lifetime Reserve Days.”  A hospital’s … [Read more...] about Saga of an Inpatient Hospital Appeal: Notice and Use of Lifetime Reserve Days and Comments on Observation Status

No Site Neutral Payments for Inpatient Rehabilitation Facilities and Skilled Nursing Facilities

The Medicare Payment Advisory Commission (MedPAC), the nonpartisan government agency that advises Congress on Medicare policy, indicated at its November 7, 2014 public meeting that, at its next public meeting in December, it would recommend (1) … [Read more...] about No Site Neutral Payments for Inpatient Rehabilitation Facilities and Skilled Nursing Facilities

Inpatient Rehabilitation Facilities and Skilled Nursing facilities: Vive La Difference!

A study assessing the outcomes of patients who were treated in inpatient rehabilitation facilities (IRFs) with clinically and demographically similar patients who received their post-acute rehabilitation in skilled nursing facilities (SNFs) finds … [Read more...] about Inpatient Rehabilitation Facilities and Skilled Nursing facilities: Vive La Difference!

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