CARES Act Includes Provisions Related to the Three-Hour Rule for IRFs

The Coronavirus Aid, Relief, and Economic Security (CARES) Act signed into law on March 27 included provisions that would waive the requirement that a Medicare beneficiary be expected to participate in at least three hours of intensive therapy, at least five days per week. This provision would improve patient access to care and assist organizations in patient transitions.

A summary of the provisions of each section of the bill can be located online. 

The specific language related to inpatient rehabilitation facilities (IRFs) is noted below:

Section 3711. Increasing Medicare Access to Post-Acute Care: This section would provide acute-care hospitals flexibility, during the COVID-19 emergency period, to transfer patients out of their facilities and into alternative care settings in order to prioritize resources needed to treat COVID-19 cases. Specifically, this section would waive the Inpatient Rehabilitation Facility (IRF) three-hour rule, which requires that a beneficiary be expected to participate in at least three hours of intensive rehabilitation at least five days per week to be admitted to an IRF.

What This Means to IRFs and Patients

By allowing IRFs more leeway in accepting patients who are appropriate for IRF but have lower tolerance, this rule provides better access for patients who require rehabilitation services. Additionally, the ruling allows IRFs to support acute-care hospitals with earlier transfer to post-acute rehabilitation, thus freeing acute beds for patients who require those services.