American Association of People with Disabilities

AAPD Addresses Medicare Restrictions on Access to Rehabilitation

Announces Participation in New Rehabilitation Services Coalition
in Face of Harmful Policies for People with Disabilities

WASHINGTON, DC, February 12, 2007 — Today, the American Association of People with Disabilities (AAPD), the nation’s largest individual membership organization for people with disabilities, expressed great concern with current Medicare policies that are severely restricting access to rehabilitation services for people with disabilities, people with serious injuries, and seniors with rehabilitation needs.

“Rehabilitation services are vital to individuals with disabilities,” stated Andrew J. Imparato, President and CEO of AAPD. “The 75% Rule is an arbitrary way of determining who gets access to intensive rehabilitation treatments and restrictive medical necessity policies are. Inpatient rehabilitation admission policies should be more evidence based. The current methods of determining who gets access to inpatient rehab threaten appropriate access to intensive rehabilitation services which, in turn, limits the possibilities for a return to full function and independent community living for members of the disability community.”

AAPD announced its rehabilitation policy concerns at a press conference held in conjunction with a research symposium designed to build a better clinical evidence base for inpatient rehabilitation admission policies. Titled the “State of the Science Symposium on Post-Acute Rehabilitation: Setting a Research Agenda and Developing an Evidence Base for Practice and Public Policy,” the symposium is the first of its kind and highlights new research findings that derive from an unprecedented research investment made by the rehabilitation community over the past year.

Anne Sommers, AAPD’s policy counsel and herself a recipient of inpatient rehabilitation spoke at the press conference and stated, “With due respect to the rehabilitation researchers and their findings, people who have undergone intensive rehabilitation provided in the inpatient setting don’t need studies and charts to know how important these services are to their ability to live active and independent lives. But if Medicare and other payers require more clinical evidence to determine who needs this level of care, then AAPD certainly supports further research in this important area.”

The so-called “75% Rule” applies to rehabilitation hospitals and units and restricts the types of patients such hospitals can admit based on a patient’s diagnosis. The impact of this restriction is essentially a quota system that leads to arbitrary judgments about who is admitted to intensive rehabilitation and who is diverted into nursing homes and lesser intense levels of care. Restrictive medical necessity policies only exacerbate the restrictions in access by using “rules of thumb” rather than the individual needs of a particular patient to determine in what setting they are treated.

The combination of these two Medicare policies have caused enormous stress on the inpatient rehabilitation system, not only requiring some rehab hospitals and units to deny individuals with certain diagnoses from receiving inpatient rehabilitative services, but forcing many to close their doors altogether.

AAPD further announced its participation in a new coalition to challenge these and related rehabilitation policies that compromise access to rehabilitation services. “Known as the Coalition to Preserve Rehabilitation or “CPR,” the coalition is being organized by AAPD and other consumer and clinician groups to breathe new life into the importance of preserving access to these vital services for people with disabilities. Stated Mr. Imparato, “CPR will serve as a much-needed consumer and clinician voice to advocate for meaningful policy changes to preserve and improve access to rehabilitation services so that people with disabilities, injuries, or chronic conditions may regain and maintain their maximum level of independent function.”

For more information on CPR, please contact Emily Niederman at 202-349-4290.

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American Association of People with Disabilities (AAPD)
1629 K Street NW, Suite 503; Washington, DC 20006
VOICE: 202-457-0046 (V/TTY) * FAX: 202-457-0473 * www.aapd.com