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Medicare Eases Rules on Reimbursement for Inpatient Rehab Services

The Centers for Medicare and Medicaid Services (CMS) has lightened up on the 3 hour time requirement for daily inpatient rehabilitation therapy. Beginning March 23rd, providers will no longer have to provide 3 hours of direct daily rehab services to patients in order to receive reimbursement. Now, CMS requires providers to assess the patient’s health and treatment plan and submit a clinical judgment as to whether or not a patient should have inpatient rehab services covered by Medicare. Many providers had complained that 3 hours was not always necessary, or that they had been just minutes shy of the 3 hour time minimum and had not received reimbursement. In fact, it has been estimated that nearly 1/4 of all inpatient rehab claims are denied by Medicare contractors, something that many providers consider when deciding where to refer patients for rehabilitation services. Instead of referring patients to facilities specifically geared towards rehabilitating patients with the intent to eventually send them home, many providers are steering patients to skilled nursing facilities to ensure they’ll receive payment. A patient in need of rehab for serious injuries would receive better treatment at a facility dedicated to rehabilitation services, but the fear of nonpayment has providers pushing patients towards those places guaranteed to pay, never a fair choice when it comes to health care.

With more than $660 million recovered for our clients and nearly 3 decades of experience, the elder abuse attorneys of Levin & Perconti are committed to passionately fighting for families who have been devastated by poor treatment of a loved one entrusted to the care of a nursing home or rehabilitation facility.

If you believe someone you love has been harmed as the result of abuse or neglect within a nursing home or rehabilitation facility, please call our elder abuse attorneys at 312-374-1417 or fill out our online case evaluation form. Consultations are free and confidential.