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  • CMS Proposed Rule Gives IRFs Their Own Market Basket, 1.7% Increase, More Reporting Requirements

    After several years of evaluating the possibilities, the US Centers for Medicare and Medicaid Services (CMS) is now ready to create a standalone payment system for inpatient rehabilitation facilities (IRFs) that will increase data reporting requirements and boost IRF payments by $130 million in 2016.

    The rule recently proposed by CMS would extract IRFs from the "market basket" that combined those facilities with psychiatric and long-term care facilities. The new IRF-only market basket would be based on cost report data from both freestanding and hospital-based IRFs and, at least initially, would be anchored in how the price of the same mix of goods and services has increased over time—in this case, the increase since 2012. Factors such as the quantity of goods and services, or changes in the mix, are not measured.

    After various additional adjustments, CMS established an average overall estimated increase for IRFs of 1.7% for 2016.

    The creation of a standalone IRF market basket will also allow CMS to more effectively apply data-reporting requirements created under the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), a law that seeks to standardize reporting across postacute care facilities. APTA supported the legislation.

    The proposed IRF rule would add 3 new reporting domains to help satisfy IMPACT Act requirements: percentage of residents with new or worsened pressure ulcers, incidence of falls, and changes in patient function and cognitive function. CMS announced that it intends to add more quality-reporting measures to future rules, mostly around changes to self-care and mobility scores in-facility and at discharge.

    According to the proposed rule, CMS would begin publically sharing IRF quality-reporting data beginning in fall of 2016.

    APTA has drafted a summary of the proposed rule (.pdf), and will provide comments to CMS on behalf of its members.


    • The link to the "summary of the proposed rule" rule goes to the SNF PPS rule not the IRF PPS rule. Can you change that?

      Posted by Donna LaFata -> ?JY\C on 5/12/2015 2:20 PM

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