October 2011 Medicare Cuts: Effects Published in Report

Among other things, the new data just released further diminishes the potential for any re-adjustment upward of the 11 % rate cuts.

CMS released its first monitoring report on the impact of the payment changes implemented October 1, 2012, which included: the recalibration of the parity adjustment (i.e.., an 11% rate cut for cases involving therapy), allocation of group therapy and changes to the MDS including the introduction of the Change-of-Therapy (COT) Other Medicare Required Assessment (OMRA).

The three key changes reported are these:

• Group Therapy (previously at 8%) is now at zero—99% of all therapy is now individual therapy;
• Substantially fewer than expected COT OMRAs have been filed, indicating that planned therapies are reported as being consistently provided as planned;
• There has been virtually no decrease in the percent of high rehab cases. CMS is now looking at data it has regarding therapy staffing (not yet fully assembled) because for the above to have occurred, either more therapy staff had to have been hired or substantial productivity increases (through better scheduling and/or changes in the types of therapists) achieved.