On April 30, 2004, the Centers for Medicare and Medicaid Services ("CMS") announced the final rule revising the criteria for classifying hospitals as inpatient rehabilitation facilities ("IRFs") for purposes of Medicare payment. CMS states that in response to extensive public comment it has modified a number of provisions found in the proposed rule. Specifically, the final rule: (i) increases from 10 to 13 the number of medical conditions that qualify as conditions used to classify a facility as an IRF; (ii) sets forth a 3-year transition period with annual increases to the number of patients in the IRF that must have a medical condition that meets one of the 13 medical conditions; (iii) establishes an administrative presumption that if the IRF's Medicare population complies with the rule, the facility's total population complies; (iv) counts patients with secondary medical conditions that match one of the 13 criteria as qualifying patients; and (v) changes the period of time to review patient data to determine compliance from the most recent 12-month cost reporting period to the most recent, appropriate, and consecutive 12-month time period. The final rule will be published in the May 7th Federal Register and will become effective for cost reporting periods beginning on or after July 1, 2004.
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