CMS Releases Fiscal Year 2020 Inpatient Rehabilitation Facility Final Rule

Posted on August 07, 2019

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

Highlights of the final rule include:

  • A net 2.5% payment increase relative to FY 2019 payments comprised of a 3% marketbasket update, offset by a statutorily mandated cut of 0.5 percentage points for productivity and a 0.2% decrease in outlier payments.
  • Removing the Functional Independence Measure items from the IRF patient assessment instrument beginning Oct. 1, 2019.
  • Updating the marketbasket to use 2016 data instead of 2012.
  • Updating the IRF wage index to use the concurrent fiscal year’s inpatient PPS wage index data for IRFs starting in FY 2020 instead of using the prior year hospital wage index.
  • Revising the case-mix groups based on two years of data (FYs 2017 and 2018) from the quality indicator data items and updating the relative weights and average length of stay values associated with the revised case-mix groups beginning on Oct. 1.
  • Amending regulations to clarify that it is the IRF’s responsibility to determine whether a physician qualifies as a rehabilitation physician.
  • Revising one measure and finalizing two new process measures for the IRF Quality Reporting Program and adopting new standardized patient assessment data elements. The CMS did not finalize its proposal 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 details regarding the final rule, including updated facility-specific impact analyses. Members with questions should contact Vickie Kunz at the MHA.

Tags: Medicare, PPS, IRF, final rule, inpatient rehabilitation facilities

Posted in: Member News

MHA Updates Delivered to You

Subscribe to the MHA Monday Report weekly newsletter or our podcast, the MiCare Champion Cast, to keep informed about the latest healthcare news and events in Michigan.

MHA Monday Report
Contact us to subscribe

MiCare Champion Cast
iTunes | SoundCloud

Media Inquiries

Contact the MHA at
(517) 703-8601

Read the MHA policy on publication via MHA media.

MHA 100 Year Anniversary

Watch the video »