United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2005-04-22 monographic deposited born digital 49 p. GA 1.13:GAO-05-366 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-05-366 P0b002ee180373c94 f:d05366 DGPO 2010-08-12 2011-03-24 GAOREPORTS-GAO-05-366 machine generated eng fdlp REPORT GAOREPORTS-GAO-05-366 GAO-05-366 Data collection Eligibility criteria Eligibility determinations Health care facilities Health statistics Medical services rates Medicare Policy evaluation Inpatient care services Other Written Product A22417 Medicare classifies inpatient rehabilitation facilities (IRF) using the "75 percent rule." If a facility can show that during 1 year at least 75 percent of its patients required intensive rehabilitation for 1 of 13 specified conditions, it may be classified as an IRF and paid at a higher rate than is paid for less intensive rehabilitation in other settings. Medicare payments to IRFs have grown steadily over the past decade. In this report, GAO (1) identifies the conditions--on and off the list--that IRF Medicare patients have and the number of IRFs that meet a 75 percent threshold, (2) describes IRF admission criteria and Centers for Medicare & Medicaid Services (CMS) review of admissions, and (3) evaluates use of a list of conditions in the rule. GAO analyzed data on Medicare patients (the majority of patients in IRFs) admitted to IRFs in FY 2003, spoke to IRF medical directors, and had the Institute of Medicine (IOM) convene a meeting of experts. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-05-366/html/GAOREPORTS-GAO-05-366.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-05-366/pdf/GAOREPORTS-GAO-05-366.pdf GAO-05-366 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-05-366 Other Written Product GAO-05-366; Medicare: More Specific Criteria Needed to Classify Inpatient Rehabilitation Facilities; Data collection Eligibility criteria Eligibility determinations Health care facilities Health statistics Medical services rates Medicare Policy evaluation Inpatient care services Volume 97 Page 65 97 Stat. 65 Volume 118 Page 2809 118 Stat. 2809 Public Law 98-21 Public Law 108-447