Proposing restoration rules will put patients at risk

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A recent article on an upcoming payment rule for hospitals and inpatient rehabilitation units, commonly known as IRFs, described a controversial Medicare proposal to allow non-specialists. (physician assistants and nurses) perform the services currently offered by War rehabilitation physicians on the pitch between provider groups. However, this ignores the voice of a third group with strong views on this patient issue.

If completed as suggested, the rule could put the patient at serious risk. Patients often come to IRFs during a crisis, after being seriously ill or injured and needing rehabilitation care and medical management. They entrust their lives to the IRF to restore their health and function. Medicare patients delay IRF providers because they believe that the federal rules governing these hospitals prove their trust in their providers. This trust is violated when non-physical physicians replace rehabilitation physicians in making large IRF care decisions.

The IRF is not a skilled nursing facility. They provide hospital-level care. IRFs treat some of the most complex Medicare patients, many who are seriously injured or sick and many comorbidities. The rehabilitation teams in the IRF are led by highly trained doctors, typically with board certification and long-term experience and expertise in medical rehabilitation.

The patients represented by our organizations have serious, permanent conditions such as the brain …



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