Recreational Therapy Case Study

The H.R. 1906 bill will revise Title XVIII of the Social Security Act to include Recreational Therapy as an intensive rehabilitation treatment program in inpatient rehabilitation facilities and allow physicians the ability to use professional judgement to provide a multitude of necessary therapeutic services.

Before 2010 the Center for Medicare and Medicaid Services stated that only four therapies were considered under the intensity of therapy requirements based on if the patient needs the treatment. This is also known as the “Three Hour Rule”. However, the CMS also included a statement stating that other therapies prescribed by physicians would satisfy these requirements if the therapeutic modality is needed. In order to meet the requirements for Inpatient Rehabilitation

This decision also took away the ability to which therapeutic services can be provided by physicians and treatment teams. By doing so it has eliminated the access for Medicare beneficiaries with injuries, disease, disabilities or chronic conditions to a multitude of necessary therapeutic services. Since then the American Therapeutic Recreation Association has attempted to get Recreational Therapy back under the three hour rule. During this time, the CMS sent documentation to Congress stating that Recreational Therapy is covered in Inpatient Rehabilitation Facilities including their costs in future payments. In 2014, Congressman Glenn Thompson introduced H.R. 4755- Access to Inpatient Rehabilitation Therapy Act of 2014, with a similar purpose as H.R. 1906. This bill died at the end of the 112th Congress. Representative Thompson re-introduced the bill in February 2015, as H.R. 1906: Access to Inpatient Rehabilitation Therapy Act of 2015, with 2 co-sponsors spearing the