The MHA recently submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding the proposed rule to update the Medicare fee-for-service (FFS) inpatient rehabilitation facility (IRF) prospective payment system (PPS) for fiscal year (FY) 2024. These comments were due to the CMS June 2.
The CMS is expected to release final rules to update the IRF, IPF and SNF PPS around Aug. 1, for the Oct. 1, 2023, effective date. The MHA will provide members with an updated Medicare FFS impact analysis following release of the final rules.
Members with questions should contact Vickie Kunz at the MHA.
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 rehabilitation facilities (IRF) for federal fiscal year (FY) 2024. Key provisions of the proposal include:
Rebasing the IRF market basket using data from cost reports beginning in FY 2021, instead of FY 2016 data.
Increasing the IRF PPS payment rate by 3.3% from $17,878 to $18,471 for IRFs that comply with the CMS IRF Quality Reporting Program (QRP) requirements. IRFs that fail to comply are subject to a two percentage point reduction.
Increasing the labor-related share from the current 72.9% to 74.1%.
Using the FY 2024 pre-floor, pre-reclassification inpatient PPS hospital wage index, with a 5% cap on any decrease to a provider’s wage index from its prior year wage index.
Decreasing the cost outlier threshold by nearly 23% from the current $12,526 to $9,690, to achieve the 3% target for outlier payments as compared to aggregate IRF payments, which will increase the number of cases that qualify for outlier payments.
Updating the IRF QRP by:
Modifying the COVID-19 Vaccination Coverage among Healthcare Personnel measure.
Adopting one new measure: The Discharge Function Score measure.
Removal of three existing measures:
The Application of Percent of Long-Term Care Hospital Patients with an Admission and Discharge Functional Assessment and a Care Plan That Addresses Function measure (NQF #2631).
The IRF Functional Outcome Measure: Change in Self-Care Score for Medical Rehabilitation Patients measure (NQF #2633.
The IRF Functional Outcome Measure: Change in Mobility Score for Medical Rehabilitation Patients measure (NQF #2634).
Modifying the excluded unit regulation to allow a hospital to open a new IRF unit and begin being paid under the IRF PPS at any time during the cost reporting period if the hospital meets certain requirements rather than the current limit that only allows for payment under the IRF PPS at the beginning of a cost reporting period.
The MHA will provide IRFs with a facility-specific impact analysis and additional details on the proposed rule in the near future. The MHA also encourages members with IRF operations to review the proposed rule, provide comments toVickie Kunz at the MHAby May 25 and submit comments to the CMS by June 2. The CMS is expected to release a final rule around Aug. 1, for an Oct. 1, 2023, effective date.
Members with questions should contact Vickie Kunz at the MHA.
Michigan’s primary election was held Tuesday, Aug. 2, finalizing the November general election ballot. The 2022 midterm election is critical to Michigan’s healthcare future given the number of key elected positions up for election …
The Centers for Medicare and Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service (FFS) hospital inpatient prospective payment system (IPPS) for fiscal year (FY) 2023. The rule will: Reduce disproportionate …
The Centers for Medicare & Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service prospective payment system for inpatient psychiatric facilities for fiscal year (FY) 2023, which begins …
The Centers for Medicare & Medicaid Services recently released a final rule to update the Medicare fee-for-service prospective payment system for inpatient rehabilitation facilities for fiscal year (FY) 2023, which begins …
The Centers for Medicare and Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service long-term care hospital prospective payment system (PPS) for fiscal year (FY) 2023, which begins Oct. …
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The Keckley Report
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“The Labor Department reported that the U.S. added 528,000 jobs in July including 69,600 in healthcare. The unemployment rate fell to 3.5%, June job openings were down to 10.7 million from 11.3 million in May and government officials announced that the economy has now recouped the 22 million jobs lost in the pandemic.
But the more sobering news is that inflation has negated the workforce’ 5.1% wage gain in the last year and 1 in 5 workers is looking for employment elsewhere for higher pay and better benefits. And it’s even worse in the healthcare delivery workforce—the hospitals, long-term care facilities, clinics and ancillary service providers where 12 million work. During the COVID-19 pandemic, hospital employee turnover increased to 19.5%–five times higher than the general workforce. And today, 45% of physicians report burnout—double the rate pre-pandemic.”
Members are reminded to review their preliminary wage and occupational mix data released May 23 by the Centers for Medicare and Medicaid Services and submit any requests for changes to their Medicare Administrative Contractor by Sept. 2 since no new requests for changes will be accepted after that date.
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The Centers for Medicare & Medicaid Services (CMS) recently released a final ruleto update the Medicare fee-for-service (FFS) prospective payment system (PPS) for inpatient rehabilitation facilities (IRFs) for fiscal year (FY) 2023, which begins Oct. 1, 2022. Key provisions of the rule include:
Requirement that the IRF-patient assessment instrument be completed on ALL patients, regardless of payor, beginning Oct. 1, 2024. This is delayed from the proposed Oct. 1, 2023 reporting date.
A 3.7% net increase to the IRF standard federal rate for providers in compliance with the CMS IRF quality reporting program, resulting in a rate of $17,878, up from the current $17,240. This increase is higher than the 2.7% proposed net increase due to comments received urging the CMS to more accurately reflect inflationary pressures experienced by IRFs and other providers.
Unchanged labor-related share with the CMS maintaining the current 72.9%.
Updated case mix group relative weights using updated FY 2021 claims and FY 2020 cost report data.
Permanent policy to limit annual wage index decreases to 5%.
A 32% increase in the outlier threshold amount from the current $9,491 to $12,526 to maintain estimated outlier payments at 3% of total estimated aggregate IRF PPS payments. This will result in fewer cases being eligible for an outlier payment.
Codification of the existing teaching status adjustment policy for IRF closures and displaced medical residents.
Indication that the CMS will respond in a potential future rule to comments received regarding expansion of the IRF transfer payment policy to include patients discharged to home health.
The MHA continues to review details of the final rule and will provide IRFs with an updated impact analysis for Medicare FFS patients in the near future. Members with questions should contact Vickie Kunz at the MHA.
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The Centers for Medicare & Medicaid Services recently released a proposed rule to update the Medicare fee-for-service prospective payment system for inpatient rehabilitation facilities for fiscal year 2023, which begins Oct. 1, 2022. Key highlights of the proposal include …
The Centers for Medicare & Medicaid Services recently released a proposed rule to update the Medicare fee-for-service prospective payment system for inpatient psychiatric facilities for fiscal year 2023, which begins Oct. 1, 2022. Key highlights of the proposal include …
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The Keckley Report
Medicare Trustees’ NHE Report: Interesting Read but Understandably Flawed
“Last Monday, Medicare Trustees released the 56th edition of their National Health Expenditures (NHE) Forecast for 2021-2030 which is widely used by policymakers and operators to gauge what’s ahead for U.S. healthcare. Regrettably, it’s flawed.”
The Circle of Life Awards recognize innovative palliative or end-of-life care providers that measure and evaluate the impact of their work on patients, family and/or the community. Part 1 applications for the 2023 awards will be accepted through May 31.
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.
The Centers for Medicare & Medicaid Services (CMS) recently included proposals related to the quality reporting programs for long-term care hospitals (LTCHs) and inpatient rehabilitation facilities (IRFs) in its proposed rule to update the Medicare fee-for-service prospective payment system for home health agencies (see related article). LTCHs and IRFs were initially scheduled to begin reporting two new quality measures Oct. 1, 2020, including Transfer of Health Information to the Provider and Transfer of Health Information to the Patient, as well as several standardized patient assessment data elements (SPADES).
Due to the COVID-19 public health emergency (PHE), the CMS declined to release updated versions of the patient assessment tools necessary for reporting this information and delayed the compliance date for reporting these items until Oct. 1 of the year that is at least one full fiscal year after the end of the COVID-19 PHE. The CMS proposes to require reporting of these measures and SPADES beginning Oct. 1, 2022, since COVID-19 cases and deaths have declined. The MHA encourages LTCHs and IRFs to submit comments to the CMS regarding this provision by Aug. 27. Members with questions should contact Vickie Kunz at the MHA.
The MHA recently submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding the proposed rules to update the Medicare fee-for-service (FFS) prospective payment systems for fiscal year (FY) 2022 for several post-acute care settings including:
The CMS proposes to adopt a new measure — COVID-19 vaccination among healthcare personnel — in the quality reporting program for these facilities and would collect data beginning Oct. 1, 2021, with the quarterly vaccination rate publicly reported on the Care Compare website. The MHA opposes the adoption of this measure prior to full approval by the Food and Drug Administration.
The CMS also included a request for information in each proposed rule seeking ways to close the health equity gap. While the MHA supports efforts to close the health equity gap, the comment letters expressed concern about the increased administration burden associated with additional quality measures and standardized patient assessment data elements. The MHA urged the CMS to honor its “Patients Over Paperwork” initiative and streamline, align and focus on measures that matter most for patient care and outcomes.
The MHA is preparing comments on the FY 2022 proposed rules to update the inpatient and long-term acute care hospital prospective payment systems and encourages hospitals to contact Vickie Kunz at the MHA by June 18 with any issues identified. Members will have access to the draft comment letters for these rules prior to the June 28 due date and are encouraged to submit their own comments. Members may direct questions on any of the proposed rules to Vickie Kunz at the MHA.