GNYHA, along with the Healthcare Association of New York State, the Northern Metropolitan Hospital Association, and the Nassau-Suffolk Hospital Council, held a joint "Inpatient Rehabilitation Facility Advocacy Day" on Oct. 3, following a morning program hosted by the American Hospital Association, the American Medical Rehabilitation Providers Association, and the Federation of American Hospitals. Representatives from the following GNYHA member hospitals participated: NYC Health and Hospitals Corporation, NYU Medical Center (representing the Rusk Institute and the Hospital for Joint Diseases), NewYork-Presbyterian Hospital, Burke Rehabilitation Hospital, and St. Charles Hospital.

The purpose of the day was to underscore the importance of including a freeze on the restrictive "Medicare 75% Rehab Rule," which continues to threaten critical access to inpatient rehabilitation facilities (IRFs). The ongoing implementation of the rule basically enforces a quota system by currently requiring that 65% of an IRF's admissions, including private-pay patients, have a primary diagnosis that falls within 13 particular conditions or diagnoses. Without further Congressional action, the compliance threshold will increase to an even more restrictive 75% threshold on July 1, 2008. At that time, comorbidities will no longer be considered for compliance purposes, making the threshold significantly more difficult to achieve.           

GNYHA, its partners in the hospital community, and IRF representatives first met with Congresswoman Nita Lowey (D-NY), who has spearheaded legislation (H.R. 4148) that would freeze the threshold at 60% and would require the development of more appropriate criteria for accessing rehabilitation services. The advocacy day included smaller group meetings with individual House representatives, including Representatives Joseph Crowley (D-NY), Tim Bishop (D-NY), and John Hall (D-NY). The group then met with the offices of Senators Charles Schumer (D-NY) and Hillary Clinton (D-NY) and staff from the Senate Finance Committee to urge the inclusion of this bill as the Senate is beginning to develop its Medicare package. 

Further, the group urged Senate offices to exclude provisions that are currently in the House Medicare package that would cut the annual inflationary update by 2.3% and would dramatically reduce IRF payments for three conditions (single hip and knee replacements, and hip fractures) to an enhanced nursing home rate. The latter provision would result in cuts totaling nearly $2 billion, while still requiring that IRFs meet all their costly regulatory requirements, including the provision of three hours of physical and occupational therapy a day, 24-hour rehabilitative nursing care, and close medical supervision by a physician with specialized training.

As Congress is expected to debate rehabilitation issues and other Medicare provisions starting later this month or early next month, GNYHA will continue to aggressively protect access to New York's rehabilitation providers.