1. Short title This Act may be cited as the Access to Inpatient Rehabilitation Therapy Act of 2023 . 2. Findings and purpose (a) Findings Congress finds the following: (1) Intensive, coordinated medical rehabilitation provided in inpatient rehabilitation hospitals and units is critical to Medicare beneficiaries with injuries, illnesses, disabilities, and chronic conditions in order to return to health, full function, independent living, and a high quality of life. (2) The Centers for Medicare & Medicaid Services (in this section referred to as CMS ) uses an intensity of therapy requirement to help determine which Medicare beneficiaries are appropriate for treatment in an inpatient rehabilitation hospital or unit. CMS has interpreted the intensity of therapy requirement through application of the so-called Three Hour Rule (42 C.F.R. 412.622(a)(3)(ii)) which requires the patient to be able to participate in 3 hours of rehabilitation therapy per day, 5 days per week, or 15 hours of rehabilitation therapy over a 1-week period. (3) In 1989, a Federal district court held that Medicare determinations for hospital rehabilitation care are to be based upon an assessment of each individual patient’s need for care and denials of admissions, services, and/or Medicare coverage based upon numerical utilization screens, diagnostic screens, diagnosis, specific treatment norms, the Three Hour Rule , or other rules of thumb are not appropriate. Hooper v. Sullivan, No. H–80–99 (D. Conn. 1989). (4) Before 2010, a CMS ruling explicitly stated that physical therapy, occupational therapy, speech therapy, and orthotics and prosthetics were counted toward the Three Hour Rule on an as-needed basis. In addition, the CMS ruling stated that other therapeutic modalities that were determined by the physician and the rehabilitation team to be needed by the patient on a priority basis would quality toward satisfaction of the rule (HCFA Ruling 85–2). (5) This language allowed physicians with specialized training and experience in inpatient