CMS Releases FY 2020 Proposed Rule for Inpatient Rehabilitation Facilities

Posted on April 18, 2019

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the Medicare fee-for-service inpatient rehabilitation facility (IRF) prospective payment system (PPS) for fiscal year (FY) 2020. The proposed rule would take effect Oct. 1, 2019.

Highlights of the proposed rule include:

  • A 2.3% payment increase relative to FY 2019 payments comprised of a 3% market-basket update, offset by a statutorily mandated cut of 0.5 percentage points for productivity, and a 0.2% decrease in outlier payments.
  • The proposed revision and rebasing of the marketbasket using 2016 data instead of 2012.
  • A change to use the concurrent FY inpatient PPS wage index data for IRFs starting in FY 2020 instead of using the prior year hospital wage index.

The rule provides additional detail about the revised IRF case mix groups that take effect in FY 2020 as finalized in the FY 2019 rule. The revised case mix groups reflect the removal of data collected by the Functional Independence Measure patient assessment instrument from the payment-setting process. In addition, the CMS proposes to modify one measure and adopt two new process measures to the IRF Quality Reporting Program and to adopt 22 standardized patient assessment data elements, plus seven more data elements related to social determinants of health. The CMS also proposes to require IRFs to report patient assessment data for the quality reporting program for all patients, regardless of payer.

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: Medicare, proposed rule, PPS, IRF, FFS, inpatient rehabilitation facilities

Posted in: Member News

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