Medicare is phasing in a rule that is restricting access to intensive inpatient rehabilitation services for many individuals with disabilities, injuries, or chronic conditions who need these services. Without access to an appropriate level of rehabilitative care, many of these individuals will wind up in nursing homes to receive a lesser level of care, which often impedes or completely prevents independence and a return to home and community! Medicare's so called "75% Rule" is restricting access to inpatient rehabilitation care by requiring inpatient rehab hospitals or units to treat a particular percentage of patients with one or more of 13 specified medical conditions. (Currently that percentage is 60% and will rise to 65% on July 1, 2007 and eventually 75% in 2008.) In other words, even if a physician finds it medically necessary for an individual to receive inpatient rehabilitative care, an inpatient rehabilitation hospital or unit may have to deny that individual access if they do not have the "right" diagnosis. It's time to act! Help us stop CMS's quota-base, healthcare rationing rule for inpatient rehabilitation services before it gets any worse! Stopgap legislation has been introduced in both the Senate and House (S. 543/H.R. 1459) that would prevent this Medicare rule from causing even greater access problems for individuals requiring inpatient rehabilitation care. WHO: Contact your Members of Congress. All Members need to hear this message! However, we are particularly focusing on Members who have supported MiCASSA, Community Choice Act, and similar versions of this legislation in previous Congresses as well as the Chair and Ranking Member of the Finance Committee. The initial target list includes the following: Sen. Ken Salazar (D CO) WHAT: Contact your Members of Congress as well as Members on the target list above and urge them to co-sponsor the "Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007" (S. 543, H.R. 1459). Call your Senators and Representatives toll-free via the capitol switchboard at 1-888-281-0661. (Go to http://www.congress.org and enter in your zip code to determine your Representatives and Senators). Tell them that people with disabilities don't want to be shuffled into nursing homes because of Medicare's quota system for inpatient rehabilitation. Tell them that people with disabilities want the best opportunity to regain functional independence, and that means that medical and rehabilitation NEED ALONE should determine who gains access to inpatient rehabilitative care in rehabilitation hospitals. BACKGROUND: The intensive rehabilitative care provided in inpatient rehab hospitals or units allows individuals disabilities, injuries or chronic conditions to regain and maintain their maximum level of function. For many individuals, access to inpatient rehab services is often the difference between returning to community living or being forced into institutional care. The "75% Rule" not only threatens access for individuals who do not have one of the 13 diagnoses, but anyone who may need inpatient rehabilitation services as well. As inpatient rehab hospitals and units struggle to meet their patient "quotas" under the rule, many are being forced to downsize, reduce services and rehabilitation programs, or close their doors altogether. This creates significant access problems for all individuals.
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