Final Rule Released for FY 2022 Inpatient Rehab Facility Prospective Payment System

The Centers for Medicare & Medicaid Services (CMS) released a final rule to update the Medicare fee-for-service prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year (FY) 2022, which begins Oct. 1, 2021.

Key provisions of the rule will:

  • Increase the standard federal rate by 2.3% from $16,856 to $17,240 for facilities that comply with the IRF quality reporting program (QRP). Facilities that fail to comply are subject to a 2 percentage point reduction.
  • Increase the cost outlier threshold by 20% from $7,906 to $9,491, resulting in fewer cases qualifying for an outlier payment.
  • Modify the IRF QRP by:
    • Adding the COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) measure, requiring IRFs to report HCP vaccinations in their facilities beginning with the FY 2023 IRF QRP.    
    • Modifying the denominator for the Transfer of Health Information to the Patient-Post Acute Care (PAC) quality measure to exclude patients discharged home under the care of a home health or hospice provider.
    • Finalizing its proposals regarding publicly reported data affected by COVID-19 reporting exemptions by calculating assessment-based measures using data from the second through fourth quarters of 2019 and claims-based measures using all four quarters of 2018 and the third and fourth quarters of 2019 for updating the Care Compare website in December 2021.

The CMS sought feedback on closing the health equity gap and is taking all comments into consideration as the agency continues efforts to address and develop policies. The CMS also continues working to improve the quality of healthcare through measurement, transparency and public reporting of data using Fast Healthcare Interoperability Resources in Support of Digital Quality Measurement within the IRF QRP, aligning where possible with other quality programs.

The MHA will provide IRFs with an updated estimated impact analysis and summary of the final rule soon. Members with questions should contact Vickie Kunz at the MHA.