Running head: H.R.

1906 ACCESS TO INPATIENT REHAB THERAPY ACT OF 2015

Legislation Paper: H.R. 1906 Access to Inpatient Rehabilitation Therapy Act of 2015

Mitzy Perez
Florida International University
Panther ID: 4159067
LEI 4720
Spring 2016

H.R. 1906 ACCESS TO INPATIENT REHAB THERAPY ACT OF 2015

H.R. 1906 Access to Inpatient Rehabilitation Therapy Act of 2015

For many years, recreational therapists have become more and more active in public
policy. In recent years, bills have been introduced to make the field of recreational therapy a
covered health care service in order to bring in more jobs, higher paying salaries and a greater
access to a range of clients. More specifically, the H.R. 1906 Access to Inpatient Therapy Act of
2015 was most recently introduced and co-sponsored by Glenn Thompson and Congressman
Butterfield of North Carolina, to amend title XVIII of the Social Security Act. This amendment
will include recreational therapy among the modalities that constitute an intensive rehabilitation
therapy program and can be counted towards the 3 hour rule (Thompson, G).
Before this bill was introduced, ATRA had made several attempts to have the Centers of
Medicaid and Medicare (CMS) clarify that recreational therapy is a covered service in Inpatient
Rehabilitation Facilities (IRF), Inpatient Psychiatric Facilities (IPF), and Skilled Nursing
Facilities (SNF). This particular project was called the ATRA Medicare Project. This included
written requests from ATRA and from legislators to clarify the language in regards to recreational
therapy. The clarification in the language would have been budget neutral, meaning that there
would be no additional costs added due to the fact that recreational therapy is already a covered
service under the CMS prospective payment system. This method did not work which led to H.R.
4248 being introduced. This movement would mandate the CMS to clarify regulatory language
in terms of recreational therapy services being provided in INFs, IPFs and SNFs and to issue a
notification in the Medicare Benefits Policy Manual that RT is a covered service in these
facilities when prescribed by physicians, required by the patients condition or part of a plan of
care (Grandal, K). H.R. 4248 died in the books when the new elections called for a new
Congress. In 2010, the CMS removed the judgment of the physician and the treatment team to

H.R. 1906 ACCESS TO INPATIENT REHAB THERAPY ACT OF 2015

determine which treatment modalities could be used to count towards the 3 hour rule in IRFs.
The 3 hour rule mandates that in order to qualify for inpatient rehabilitation, a patient must be
able to benefit from 3 hours of intensive therapy 5 days a week (15 hours over a 7 day period)
(Centers for Medicare and Medicaid). H.R. 4755 Access to Inpatient Rehabilitation Therapy Act
of 2014 was introduced to amend title XVIII of the Social Security Act to include RT as a
modality that qualify for an intensive therapy program in IRFs, but as H.R. 4248, H.R. 4755
died ended along with the 112th Congress with 5 co-sponsors.
Through the use of evidence based practice, created and led by a qualified therapist,
recreational therapy improves the functional capacities and quality of life of people with
disabilities/illnesses. As mentioned earlier, H.R. 1906 Access to Inpatient Rehabilitation Therapy
Act of 2015 was introduced by Glenn Thompson and co-sponsored by North Carolina
Representative Butterfield with the purpose of amending title XVIII of the Social Security Act.
As stated on the ATRA federal policy website, this bill would restore reliance on the physician
and treatment teams judgment when determining whether a Medicare patient meets the intensity
requirement of an inpatient rehabilitation hospital or unit in order for the patient to be granted
access to therapeutic services such as physical therapy, occupational therapy, and as prescribed,
recreational therapy (Federal Public Policy). Recreational therapy would be prescribed by a
physician depending on if the patients state of health would require it to be a part of the
treatment plan.
Aside from the fact that the federal government would not need to put out more money in
order for recreational therapy to be a covered service, since it is already covered, this amendment
will allow treatment teams to have a wider range of therapeutic rehabilitation modalities that will
greatly improve the patients state of health and have less readmissions after discharge.

H.R. 1906 ACCESS TO INPATIENT REHAB THERAPY ACT OF 2015

References
Federal Public Policy. (n.d.). Retrieved March 08, 2016, from https://www.atraonline.com/policy/federal-public-policy
Grandal, K. (n.d.). Re-Creative Resources. Retrieved March 05, 2016, from
http://www.theactivitydirectorsoffice.com/ReCreative_Resources-Archive200806.html
Inpatient Rehabilitation Therapy Services: Complying with Documentation Requirements. (n.d.).
Retrieved March 5, 2016, from https://www.cms.gov/
Skalko, T., & Williams, R. (n.d.). HR 1906: Access to Inpatient Rehabilitation Therapy Act of
2015 and the Role of the Recreational Therapist in Public Policy. Retrieved March 5,
2016, from https://www.atra-online.com/assets/pdf/policy/federal-publicpolicy/ATRA_FPP_2015_Annual_92815_pm.pdf
Thompson, G. (n.d.). H.R. 1906. Retrieved March 5, 2016, from
https://www.congress.gov/114/bills/hr1906/BILLS-114hr1906ih.pdf