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To: Dan Meleney who wrote (37748)5/5/2010 9:24:54 AM
From: JakeStraw  Read Replies (1) | Respond to of 78707
 
FVE - The reason I mentione that is the following from their recent Form 10-Q

Federal agencies and some members of Congress have proposed Medicare and Medicaid policy changes and freezes on rate increases or rate reductions to be phased in during the next several years. The current economic conditions are causing budget shortfalls in many states, increasing the likelihood of Medicaid rate reductions, freezes on rate increases, or increases that are insufficient to offset increasing operating costs. The new comprehensive health care reform law described below includes policy changes and provisions that may result in reduced Medicare rates of payment for SNFs and IRFs or a failure of such rates to cover our cost increases over the next several years. The magnitude of the potential Medicare and Medicaid rate reductions or changes and the impact on us of the failure of these programs to increase rates to match increasing expenses, as well as the impact on us of the future and potential Medicare and Medicaid policy changes, cannot currently be estimated, but they may be material to our operations and may affect our future results of operations.

In May 2004, CMS issued the "75% Rule" establishing revised Medicare criteria that rehabilitation hospitals are required to meet in order to participate as IRFs in the Medicare program. As recently amended, the rule requires that for cost reporting periods starting on and after July 1, 2006, 60% of a facility's inpatient population must require intensive rehabilitation services for one of the CMS's designated medical conditions. The rule is now commonly known as the "60% Rule". An IRF that fails to meet the requirements of this rule is subject to reclassification as a different type of healthcare provider; and the effect of such reclassification would be to lower Medicare payment rates. As of March 31, 2010 and May 3, 2010, we believe our IRFs are in compliance with the CMS requirements to remain IRFs. However, the actual percentage of patients at our IRFs who meet these Medicare requirements may not be or remain as high as we believe or may decline. Our failure to remain in compliance with CMS requirements to be paid as an IRF, if it occurs, will result in our receiving lower Medicare rates than we currently receive at our IRFs.

On March 23, 2010, President Obama signed a comprehensive health care law, H.R. 3590, the Patient Protection and Affordable Care Act, or PPACA. A week later, President Obama signed H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010, amending PPACA. As amended, PPACA contains insurance changes, payment systems changes, and healthcare delivery systems changes, with the stated intention to expand access to health insurance coverage and simultaneously reduce the growth of healthcare expenditures while maintaining or improving healthcare quality. Under PPACA, most individuals will be required to have or purchase qualifying employer based or individual health insurance plans beginning in 2014. Premium and cost sharing tax credits will be available to assist people with low incomes to purchase health insurance, Medicaid eligibility will be expanded to more low income individuals, statewide and regional insurance exchanges will be established to expand access to standardized health insurance plans, and employers with more than 50 employees will be subject to financial penalties if any of their full time employees receive premium credits to purchase health insurance through an exchange. At this time it is unclear if all or any of the stated intentions of the PPACA, some of which are intuitively contradictory, can or will be achieved.
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