The Academy’s Advocacy Efforts Are Working for You!

In Brief: On December 29, 2007, President Bush signed into law Medicare legislation that positively impacts physiatrists. Below are more details on provisions of the new law.

Huge Win for Physiatrists – A Permanent Fix on Medicare’s “75% Rule”

The Academy successfully advocated for legislation that was enacted to permanently freeze implementation of the “75% Rule” at the 60% level. The law allows comorbid conditions to continue to count toward meeting the rule’s threshold. Additionally, the law requires that the Department of Health and Human Services study beneficiary access to inpatient rehabilitation services and make recommendations for classifying inpatient rehabilitation hospitals and units. While the Academy works toward the long-term goal of passing legislation that will remove admissions quotas and return the physiatrist to the position of freely determining what type of rehabilitation is medically necessary for any given patient, the Academy supports the above provisions as an intermediate step in improving access to acute comprehensive rehabilitation for people with disabilities. This provision constitutes a huge victory for the specialty!

10% Medicare Physician Payment Cut Averted

The original Medicare physician payment cut of 10% has been changed to a 0.5% increase until June 30, 2008. This is a temporary fix of the Sustainable Growth Rate (SGR). The Academy will continue to aggressively advocate for the repeal of the SGR and revision of the system to reflect actual practice costs. 

Exceptions Process for Outpatient Therapy Caps Extended

The new law also requires Medicare to extend the current exceptions process for the caps on outpatient rehabilitation therapy services through June 30, 2008. This allows for continued access to outpatient rehabilitation therapy for the most vulnerable Medicare beneficiaries, those who need rehabilitation services the most. Congress will likely address this issue again before this extension expires. The Academy will continue to strongly advocate for a long-term fix.

Restriction on Allowable Medicaid Rehabilitation Services Delayed

Additionally, the law places a six-month moratorium on the issuance of final regulations to restrict allowable services under the Medicaid Rehabilitation services option. The Academy will continue to strongly advocate to prevent implementation of the final regulations.

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