State Public Policy Action Needed
Inpatient Rehabilitation Local Coverage Determination
Massachusetts and Maine

ATRA Members,

ATRA has been responding to individual Fiscal Intermediaries Local Coverage Determination proposals since Fall 2003. (For a review of ATRA responses, go to the archive files on the website under Public Policy.)

The Fiscal Intermediary in Massachusetts and Maine, Associated Health Services, has issued a Local Coverage Determination with June 21, 2004 as the deadline for public comments.

We recommend all ATRA members in the states of Massachusetts and Maine respond to this action alert using the attached sample letter.

LCD for Inpatient Rehabilitation (DL 16555) Talking Points

1. Commend Associated Health Services (AHS) for making important clarifications in the Medicare guidelines that will increase consistency in interpretation, implementation and evaluation at the agency level.

2. Request AHS add “recreational therapy” as an identified skilled rehabilitation modality in the section specifically identifying medically reasonable and necessary inpatient rehabilitation therapies.

3. Provide examples of recreational therapy interventions and outcomes that support the identification of recreational therapy as a skilled rehabilitative modality.

4. Write your letter prior to June 21, 2004 and provide a courtesy copy to the ATRA National Office (hard copy by mail or email to national@atra-tr.org).

Attached Documents:

ATRA Response to AHS LCD web posting

Massachusett and Maine LCD ATRA Sample letter