CMS released its final fiscal year 2018 rule for Medicare inpatient rehabilitation facilities, which includes payment policies and rates for the Inpatient Rehabilitation Facility Prospective Payment System as well as the IRF Quality Reporting Program.
Here are seven things to know about the 2018 final rule.
1. CMS is updating the prospective payment rates for inpatient rehabilitation facilities for next fiscal year, including payment rates under the IRF PPS. The agency said updates to IRF PPS payments for fiscal year 2018 include a 1 percent increase factor. That's per section 1886(j)(3)(C)(iii) of the Social Security Act, as added by section 411(b) of the Medicare Access and CHIP Reauthorization Act of 2015. CMS said there is also an additional approximate 0.1 percent decrease to aggregate payments "due to updating the outlier threshold." Overall, CMS estimates IRFs will receive $75 million in increased federal payments during fiscal year 2018 compared to the prior fiscal year.
2. While CMS is updating IRF PPS payments, the agency did not finalize any changes to the facility-level adjustments for fiscal year 2018. CMS said it "will continue to maintain the facility-level adjustment factors at current levels as we continue to monitor the most current IRF claims data available to assess the effects of the FY 2014 changes."
3. The rule finalizes the removal of a 25 percent payment penalty that applied to late IRF patient assessment instrument submissions.
4. In the rule, CMS also revises ICD-10-CM diagnosis codes that help figure out an IRF's 60 percent rule compliance calculation to determine "presumptive compliance." CMS said it is doing this by "counting certain ICD-10-CM diagnosis codes for patients with traumatic brain injury and hip fracture conditions," and by "revising the presumptive methodology list for major multiple trauma by counting IRF cases that contain two or more of the ICD-10-CM codes from three major multiple trauma lists in the specified combinations."
5. Additionally, CMS is finalizing various technical IRF process revisions, such as finalizing the removal of a voluntary item for swallowing status from the IRF-Patient Assessment Instrument.
6. The agency said six additional quality measures will also be on the IRF Compare website for next calendar year.
7. The rule is slated to take effect Oct. 1.
Download the full IRF PPS rule here.
More articles on healthcare finance:
Wyoming hospital at risk of losing Medicare, Medicaid funding
Kindred to close Ohio hospital, lay off 111 employees
HCA sees Q2 earnings lag, stays ready for more acquisitions