IRFs unhappy with new Medicare requirement
Rehab Regs, December 9, 2004
Inpatient rehab facility (IRF) advocates accompanied the American Physical Therapy Association in a meeting last week with CMS to object to a new requirement for assessing the medical necessity for inpatient rehabilitation, according to PT Bulletin Online. Under the requirement, the fiscal intermediary (FI) can deny rehabilitation if it determines the care could have been provided in a "less intensive setting," even when the patient meets all of the requirements in the CMS manual for IRF care. The coalition argued that giving FIs such wide discretion could result in a patient receiving less care than he or she needs. CMS officials disagreed, arguing that an FI has the ability to make decisions about appropriate levels of care.
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