AHA urges CMS to re-evaluate 'arbitrary access restrictions' for IRF patients

AHA today urged the Centers for Medicare & Medicaid Services to address problems with the “60% Rule” for inpatient rehabilitation facilities, especially the policy’s “arbitrary access restrictions” for patients with diagnoses outside of the 13 qualifying conditions. Commenting on the agency’s proposed rule for the IRF prospective payment system for fiscal year 2018, AHA also addressed concerns related to the coding guidelines for the 60% Rule presumptive compliance test and the rule’s quality reporting provisions. “Specifically, while we support several of the proposed coding changes, we have concerns with others, as well as the rule’s lack of transparency on the rationale supporting some of these changes,” wrote AHA Executive Vice President Tom Nickels. “In addition, we urge CMS to reconsider changes made to one measure in the IRF quality reporting program, and delay the implementation of new standardized patient assessment data elements into the IRF Patient Assessment Instrument.”