Last week, GNYHA submitted its comment letter to the Centers for Medicare & Medicaid Services (CMS) on its proposed 75% rule for inpatient rehabilitation facilities (IRFs). (See related articles in Skyline News, Sept. 8, Oct. 6, and Oct. 20.) GNYHA's principal comment was that CMS should sponsor a formal study of potential access problems and differences in clinical and functional outcomes-both short-term and longterm -among patients with comparable conditions who receive rehabilitation in different post-acute care settings. Based on the findings of the study, CMS should identify the clinical conditions and functional status of patients for whom care in an IRF is medically necessary, and so modify the 75% rule. In addition, CMS should not implement the 75% final rule until the study is complete and the rule can be modified to ensure adequate patient access and outcomes. The final rule is expected to be published in the Federal Register in the near future.

Representative Nita Lowey speaking at the October 23 press conference.

Advocacy: GNYHA continues to push for a legislative fix to the rule, as well. On October 21, GNYHA joined several members for an American Hospital Association/American Medical Rehabilitation Providers Association lobby day in Washington,D.9C. The purpose of the event was to educate members of the New York Congressional Delegation about the 75% rule and the devastating impact it would have on Medicare beneficiaries and GNYHA members with IRFs. Participants also asked delegation members who had not yet signed the "Dear Colleague" letters spearheaded by Representatives Nita Lowey (DNY), Frank LoBiondo (R-NJ), and John Tanner (D-RN) in the House, and Senator Ben Nelson (R-NE) in the Senate, to do so. Finally, GNYHA members thanked New York delegation members who had already signed.

On October 23, Representative Lowey held a press conference at Burke Rehabilitation Hospital to raise awareness of the issue and the critical need for changes to be made to the rule in order to protect patient access to medically needed rehabilitation services. GNYHA is grateful to Representative Lowey for her leadership on this issue.