Supporting the Physiatrist, Strengthening the Specialty

CMS is proposing to implement a “Review Choice Demonstration” for IRFs, which would subject selected IRFs to 100% pre-claim or post-claim review of their Medicare claims. While this demonstration would begin with all IRFs in Alabama, CMS proposes to expand the RCD to all providers in four Medicare Administrative Contract (MAC) jurisdictions, covering 17 states, three U.S. territories and the District of Columbia. We believe that this RCD would add significant burden to physiatrists working in IRFs and fundamentally alter the patient population by allowing MACs to overrule admitting physician decisions and curtail access to IRFs for patients under Medicare coverage if the MAC determines the IRF care is not appropriate for the patient. We encourage you to use our template to submit your own, individualized letter to CMS opposing this proposed IRF RCD by Friday, October 8.

CMS is proposing to implement a “Review Choice Demonstration” for IRFs, which would subject selected IRFs to 100% pre-claim or post-claim review of their Medicare claims. While this demonstration would begin with all IRFs in Alabama, CMS proposes to expand the RCD to all providers in four Medicare Administrative Contract (MAC) jurisdictions, covering 17 states, three U.S. territories and the District of Columbia. We believe that this RCD would add significant burden to physiatrists working in IRFs and fundamentally alter the patient population by allowing MACs to overrule admitting physician decisions and curtail access to IRFs for patients under Medicare coverage if the MAC determines the IRF care is not appropriate for the patient. We encourage you to use our template to submit your own, individualized letter to CMS opposing this proposed IRF RCD by Friday, October 8.