The Centers for Medicare & Medicaid Services (CMS) released a proposed rule to update the Medicare fee-for-service prospective payment system (PPS) for inpatient psychiatric facilities (IPFs) for fiscal year (FY) 2022 which begins Oct. 1, 2021.
The IPF proposed rule would:
- Provide a net 2.2 % increase to the federal per diem base rate, increasing it from $815.22 to $833.50, while also increasing the payment for electroconvulsive therapy treatment from $350.97 to $358.84. IPFs that fail to comply with CMS quality reporting program requirements are subject to a 2 percentage point reduction to the federal rates.
- Result in a slight decrease to the labor-related share from 77.3% to 77.1%.
- Decrease the cost outlier threshold by 4% from the current $14,630 to $14,030, which should result in slightly more cases qualifying for an outlier payment.
- Update the IPF PPS teaching policy for IPF hospital closures and displaced residents, making it consistent with changes included in the FY 2021 inpatient PPS final rule.
- Modify the IPF quality reporting program by:
- Adopting voluntary patient-level data reporting for data submitted for payment determination for FY 2023 and mandatory patient-level data reporting for payment determination for FY 2024 and future years.
- Adopting the COVID-19 Healthcare Personnel Vaccination measure for the FY 2023 payment determination and subsequent years.
- Adopting the Follow-up After Psychiatric Hospitalization (FAPH) measure for the FY 2024 payment determination and subsequent years.
- Removing four measures starting with FY 2024 payment determinations:
- Alcohol Use Brief Intervention Provided or Offered and Alcohol Use Brief Intervention Provided (SUB-2/2a).
- Tobacco Use Brief Intervention Provided or Offered and Tobacco Use Brief Intervention Provided (TOB-2/2a).
- Timely Transmission of Transition Record (Discharges from an Inpatient Facility to Home/Self Care or Any Other Site of Care).
- Follow-up After Hospitalization for Mental Illness (FUH).
Within the proposed rule is a Request for Information (RFI) seeking input on closing the health equity gap in the CMS quality programs. The agency seeks to base reporting of health disparities on social risk factors and race and ethnicity so it is more comprehensive and actionable for facilities, providers and patients. The CMS will use the feedback to inform a future, comprehensive RFI focused on closing the health equity gap in the CMS programs and policies.
The CMS will accept comments on the proposed rule until June 7. The MHA will provide IPFs with an estimated impact analysis and summary of the proposed rule within the next month. Members with questions should contact Vickie Kunz at the MHA.