ACTION ALERT

Action Alert: AHCA Opposes New Bill that Supports Access to Rehabilitation

April 16th, 2007

The American Health Care Association (AHCA) believes the best place to receive rehabilitation services are in a nursing home.  If you agree with AHCA, no need to read on, but if you think rehabilitation is best provided by qualified rehabilitation specialists, action is needed! 

 The “Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007” S. 543 was introduced in the Senate by U.S. Senators Nelson, Bunning, Stabenow and Snowe and H.R. 1459 was introduced in the U.S. House by Representatives Tanner, Hulshof, Lowey and Lobiondo. This legislation will help ensure that individuals in need of intensive inpatient rehabilitation services will have access to these types of services rather than being shuffled off into a nursing home.

The determination of one’s rehabilitative needs is an extremely personal process involving the individual, their family, and their team of rehabilitation doctors and other clinicians.  It is not a decision that should be dictated by a government policy based on an individual’s diagnosis alone. By basing admission solely on an individual’s diagnoses, rather than his/her specific medical and rehabilitation needs, the 75% Rule threatens access to care for those requiring intensive rehabilitation, including transplant patients, cardiac patients, and others, whose condition may not satisfy the rule. The 75% Rule is currently being debated. It is basically a quota system that arbitrarily determines who can and cannot receive inpatient rehabilitation care based simply on one’s medical diagnosis and the time of admission. Attached is a letter AHCA is circulating in Congress that should cause great concern for advocates across the nation. 

Call your U.S Senators and Representatives via the Capitol switchboard at:

1-202-224-3121 and ask them to co-sponsor S. 543/H.R. 1459 to keep people out of nursing homes and ensure quality care is given in the most appropriate setting. Please contact Elizabeth Leef at Elizabeth@ncil.org for further information.

For Immediate Release Contact: Susan Feeney

February 14, 2007 (202) 898-9354

AHCA: Preserving Medicare “75% Rule” Provides U.S. Seniors Highest Quality Care in Most Cost-Efficient Manner; Congress Urged to Preserve Key Pro-Senior, Pro-Taxpayer Measure Washington, DC

The American Health Care Association (AHCA) said today that newly-introduced legislation that would weaken Medicare’s so-called “75% Rule” – the Preserving Patient Access to Inpatient Rehabilitation Hospitals Act – is contrary to the continued provision of quality long term care to America’s most vulnerable seniors. As well they noted that it is also contrary to the interests of U.S. taxpayers who deserve to see Medicare resources spent in the most efficient, effective manner possible. “The debate surrounding the Medicare ‘75% Rule’ is highly relevant to today’s health care policy
debate. We want lawmakers to understand that objective analysis finds preserving current law is the best way to protect seniors’ care quality, and promote the most efficient use of taxpayer dollars,” stated Bruce Yarwood, President and CEO of AHCA. “Legislation to weaken the ‘75% Rule’ is misleading in its claims – and undermines necessary efforts to transform the healthcare culture to one that provides seniors with quality care at the lowest, most cost effective rate."
The “75% Rule” was crafted to ensure that Medicare beneficiaries receive rehabilitative care in the most appropriate setting for their needs. Most often, patients receive their rehab care in either an Inpatient Rehabilitation Facility (IRF) or a Skilled Nursing Facility (SNF). During the period of nonimplementation of the rule, IRFs were treating many patients who could receive the same quality care
in a more cost effective setting, such as a skilled nursing facility.
The “75% Rule” differentiates the truly high acuity patients who need intensive rehabilitation services provided in a hospital setting from those who could be cared for in other settings, like SNFs, at the same high level and quality – and at a significantly lower cost to the Medicare program.
In addition to that fact the Centers for Medicare and Medicaid Services (CMS) previously estimated failure to fully implement the 75% Rule could cost taxpayers an additional $370 million annually in Medicare spending, McKnight’s Long Term Care News – in an article entitled, “CMS: Results Show 75% Rule Detractors Have Flawed Logic” dated December 7, 2005, that: “A new governmental report reinforces the importance of the 75% rule… and also discredits an earlier hospital-industry supported paper that sought to undermine the rule amid lawmaker efforts to revise it.”…
“While IRFs cost the government about $800 per patient day, reimbursement to nursing homes is closer to just $350 per day.”
“Maintaining current law will help protect limited Medicare funds and ensure our nation's frail, elderly and disabled have access to critical rehabilitative services in the most appropriate care setting, concluded Yarwood. “Ultimately, patients and taxpayers are the winners from the ‘75% Rule’ – and the facts show the law should be maintained in its current state.”