CMS is proposing to implement a
“Review Choice Demonstration” for IRFs, which would subject selected IRFs to
100% pre-claim or post-claim review of their Medicare claims. While this
demonstration would begin with all IRFs in Alabama, CMS proposes to expand the
RCD to all providers in four Medicare Administrative Contract (MAC)
jurisdictions, covering 17 states, three U.S. territories and the District of
Columbia. We believe that this RCD would add significant burden to physiatrists
working in IRFs and fundamentally alter the patient population by allowing MACs
to overrule admitting physician decisions and curtail access to IRFs for
patients under Medicare coverage if the MAC determines the IRF care is not
appropriate for the patient. We
encourage you to use our template to submit your own, individualized letter to
CMS opposing this proposed IRF RCD by Friday, October 8.