Increase Access to Care for Individuals with Brain Injury
Ensure Patient-Centered Access to Rehabilitation
When an individual sustains a brain injury, life-saving treatment is only the first step in recovery. Post-acute rehabilitation of sufficient scope, duration, and intensity delivered in inpatient rehabilitation hospitals and units (IRFs), residential/transitional rehabilitation facilities, and community-based outpatient programs is vital for regaining health, function, and independence. Each day, it becomes more difficult for patients with individual and group health insurance plans, as well as Medicare and Medicaid beneficiaries, to access the rehabilitation they need.
Ways to Overcome Barriers to Access:
- Oppose efforts to restrict access to rehabilitative services and devices in all settings of care.
- Reform the use of prior authorization in Medicare Advantage by passing H.R. 3107; the Improving Seniors’ Timely Access to Care Act, and reject the use of prior authorization for IRF patients.
- Oppose the proposed Medicare demonstration project that seeks to impose pre-claim or post-claim review of 100% of IRF claims.
- Ensure that efforts to design and implement a Medicare uniform
post-acute care (PAC) payment system do not negatively impact access for people with brain injury and other complex conditions.
- Continue the telerehabilitation flexibilities after the COVID-19 public health emergency ends while ensuring that access to in-person care is maintained and improved.
- Develop a permanent fix for the reimbursement cuts to therapists and other providers under the 2021 Physician Fee Schedule.
- Revise the so-called “three-hour rule” to expand access to all appropriate skilled therapies provided in IRFs (Access to Inpatient Rehabilitation Therapy Act).