Rule Proposes Changes to Inpatient Psychiatric Facility Payments in 2020

Posted on April 23, 2019

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the Medicare fee-for-service prospective payment system (PPS) for inpatient psychiatric facilities (IPFs) for fiscal year (FY) 2020. Highlights of the proposed rule include:

  • A 2.6% increase in the per diem base rate from the current $782.78 to $803.48 for facilities that comply with the CMS quality data reporting requirements. Excluding budget neutrality, the proposal includes a net 1.85% marketbasket increase. That figure is reached after the 3.1% marketbasket increase is reduced by the 0.5 percentage point productivity adjustment mandated by the Affordable Care Act and a 0.75 percentage point reduction.
  • An estimated 1.7% overall increase in IPF payments relative to FY 2019 payments, when all changes are considered.
  • A revision of the marketbasket to use 2016 data as the base year instead of 2012 data, which has been used since the inception of the IPF PPS.
  • A change to use the concurrent inpatient hospital PPS wage index data for IPFs starting in FY 2020 instead of using the prior year hospital wage index.
  • Adoption of the new Medication Continuation Following Inpatient Psychiatric Discharge (National Quality Form #3205) claims-based measure to track whether patients admitted with diagnoses of major depressive disorder, schizophrenia or bipolar disorder fill at least one prescription for an evidence-based medication to use after discharge. If finalized, discharges in the performance period July 1, 2017, through June 30, 2019, would be used for the FY 2021 payment determination. The addition of this measure would result in 14 total measures in the IPF quality reporting program.

In the coming weeks, the MHA will provide additional information regarding the proposed rule, including a facility-specific impact analysis. The association will also make its draft comments available and encourages members to submit their comments to the CMS prior to the June 17 due date. Members with questions should contact Vickie Kunz at the MHA.

Tags: proposed rule, CMS, inpatient, IPF PPS, psychiatric, FY 2020

Posted in: Member News

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