Medicare Compliance & Reimbursement

Inpatient rehabilitation hospitals would get a 3.3 percent reimbursement increase under a proposed rule to be issued May 16 by the Centers for Medicare & Medicaid Services, the agency announced May 8. A prospective payment system for these facilities became effective as of Jan. 1, 2002. CMS said that, as of Sept. 30, 2003, it was re-instituting enforcement of the "75 percent rule." This regulation requires rehab hospitals to show that at least three-quarters of their inpatient population over the most recent 12-month cost reporting period required "intensive rehabilitation services for 10 serious medical conditions," such as stroke, amputations, and brain injuries. "Because of concerns regarding the effectiveness and consistency" of the procedures that Medicare contractors were using to enforce the 75 percent rule, CMS had suspended enforcement in July, 2002.