What’s happening: Several California representatives joined fellow members of Congress in urging the Centers for Medicare & Medicaid Services (CMS) to take steps that will ensure Medicare Advantage (MA) plan beneficiaries have access to medically necessary inpatient rehabilitation facility (IRF) care.
What else to know: In the letter, the authors observe that, by statute, MA must cover all services included under traditional Medicare, including inpatient rehabilitation — an essential service for many beneficiaries when recovering from a major medical event.
However, MA patients utilize inpatient rehabilitation at less than half the rate of their counterparts in Original Medicare, raising concerns about access to medically necessary care. The writers’ request that CMS develop and implement time and distance network adequacy requirements for IRF care, as is the case for skilled-nursing facilities and inpatient psychiatric facilities.