October 8, 2021
California will be among 17 states in which the Centers for Medicare and Medicaid Services (CMS) plans to initiate a 5 year project to review all claims submitted for inpatient rehabilitation facility (IRF) services. IRFs provide intensive rehabilitation and care coordination that people may need to recover after a medical event such as a heart attack, a stroke, or a traumatic brain or spinal cord injury. Just as importantly, people with chronic conditions and disabilities may need IRF services to maintain their functional capacity and prevent or slow down functional deterioration experienced over time. A temporary IRF stay can mean a faster and more efficient return to the community. CMS has provided little evidence of the fraud that is cited as justification for the demonstration, and we already know that IRF services can be denied to people with disabilities even when they are of medical benefit, especially people with chronic progressive conditions who are already too often "written off" because they cannot be cured or "fixed." In our comment letter, DREDF opposed gatekeeping measures that stop people with disabilities from getting the care they need to live fully and independently in their communities. [...]