ISMA is joining the AMA, the American Academy of Physical Medicine and Rehabilitation (AAPM&R) and other physician organizations in voicing concerns about proposed changes to Medicare scope of practice requirements at inpatient rehabilitation facilities (IRFs).

In a June 11 letter to the Centers for Medicare and Medicaid Services (CMS), the physician groups comment on a new rule that would let non-physician providers (NPPs) perform tasks and services now required to be performed by rehabilitation physicians –  including medical supervision, developing patient plans of care and leading interdisciplinary team meetings. CMS issued the proposal under Executive Order 13890, which the AMA, ISMA and others raised concerns about last year.

“Rehabilitation physicians are the most highly educated and trained health care professionals within IRFs and should be maintained as the authorized leaders of the health care team,” the new letter to CMS Administrator Seema Verma said. “Allowing NPPs with comparatively less education, training, and experience to take on rehabilitation physician responsibilities increases the risk of significant, problematic unintended consequences for IRF patients.

“Such action threatens the health and safety of this uniquely complex patient population and could result in inappropriate care plans, poor or sub-optimal patient outcomes, and inappropriate and unnecessary use of limited resources, potentially including inappropriate admissions, prolonged delivery of high-cost services, high-cost complications of mismanaged co-occurring conditions, and inappropriate and unnecessary use of equipment and supplies.”

The letter concludes by requesting CMS not to finalize the scope-of-practice changes.

Read the complete letter to Administrator Verma here.