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Your Help is Needed to Protect Access to Inpatient Rehabilitation Care.

Currently, Medicare is phasing-in the harmful “75% Rule” which arbitrarily restricts who can and cannot access vital inpatient rehabilitation care. For individuals with disabilities, chronic conditions, and injuries, appropriate access to intensive, coordinated rehab care can often mean the difference between returning to independent living or being diverted into an institutional setting for care (e.g. nursing homes).

Action Requested:

In the next few weeks, the Senate Finance Committee is expected to introduce a large Medicare bill that would address several Medicare-related priorities in a single legislative package. Your help is needed immediately to ensure that Senate Finance Committee leaders include provisions to address the harmful 75% Rule in their Medicare package and maintain continued access to inpatient rehabilitation care.

Please call Senate Finance Committee Chairman Max Baucus (D-MT) at (202) 224-2651 and Ranking Republican Charles Grassley (R-IA) at (202) 224-3744 and ask that they include provisions in the final Medicare bill to prevent further harm by the 75% Rule. Please feel free to use the talking points below.

Talking Points on Medicare’s 75% Rule:

• I urge you to address the harmful 75% Rule in you Medicare package this year because this is an important issue for individuals with disabilities and chronic conditions.
  
  
• I support access to medically necessary rehabilitative services provided in the appropriate setting, whether that setting is an inpatient rehabilitation hospital or unit, skilled nursing facility, or on an outpatient basis.
  
  
• However, I strongly oppose the use of the 75% Rule, which is an arbitrary quota-based rule that has the effect of restricting access to intensive rehabilitation services in inpatient settings based solely on a patient’s diagnosis, rather than on their total rehabilitative and medical needs.
  
  
• Please help maintain access to healthcare that facilitates independent living for people with disabilities. Individuals must have access to appropriate inpatient rehabilitation services that will enable them to function as fully as possible in their homes and communities.

Background on the 75% Rule:

The 75% Rule, currently being phased-in by CMS, states that inpatient rehab hospital and units must maintain a particular percentage of patients with one or more of 13 conditions in order to retain their qualifications. As a result, facilities are often forced to deny access to necessary inpatient rehabilitation services to individuals who meet the strict admission criteria, but who do not happen to have one of the thirteen conditions on the list. 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. Stopgap legislation (S. 543/HR 1459) to hold the required percentage at 60% is currently pending in both the Senate and House.

Please contact the Coalition to Preserve Rehabilitation (CPR) with any questions at (202) 349-4290.