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The final 2018 rules for inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs) released by the US Centers for Medicare and Medicaid Services (CMS) don't vary much from the proposed versions issued this spring, following through with proposals for an overall 1% payment increase, changes to reporting requirements, and updates to the list of ICD-10-CM codes the agency uses to evaluate facility compliance with the so-called “60% rule.” That rule states that 60% of an IRF's patients must require treatment for 1 or more specified conditions.

As in the proposed rules, payment increases amounting to $80 million for IRFs and $390 million for SNFs are included, as are increased quality-reporting requirements—and consequences for noncompliance. More detail on the proposed rules appears in a PT in Motion News story published in May. CMS has published fact sheets on both the SNF and IRF final rules.

In its comments to CMS on the proposed rules (SNF comments here, IRF comments here), APTA supported several provisions, including a plan to revamp the existing "pressure ulcer quality" measure and remove the "all-cause unplanned readmission" measures. Additionally, the association agreed with CMS on its plan to update the list of codes on the "presumptive compliance list," the list on which the 60% rule is based. Those proposed changes remain in the final rules.

APTA regulatory affairs staff members are reviewing both final rules and will publish highlights in the coming weeks. PT in Motion News will share links to those highlights when they become available.


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