Long-term Care Hospital Prospective Payment System Proposed Rule Released

Posted on May 14, 2020

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the Medicare fee-for-service long-term care hospital (LTCH) prospective payment system (PPS) for fiscal year (FY) 2021, which begins Oct. 1. The proposed rule would:

  • Provide a net 2.75% increase in the LTCH standardized operating rate for facilities that successfully comply with the LTCH quality reporting program (QRP) requirements.
  • Pay all site-neutral cases, defined as cases that do not meet the established clinical criteria, at the site-neutral rate, rather than based on a 50/50 blend of the LTCH PPS and site-neutral rates.
  • Rebase and revise the LTCH marketbasket to reflect more current LTCH costs.
  • Update the wage index values used for the LTCH PPS, including a 5% stop loss provision to ensure that the wage index for each facility is at least 95% of its FY 2020 value.
  • Make no changes to the LTCH QRP.

The MHA will provide a facility-specific analysis and a summary of the proposed rule within the next few weeks. The association encourages facilities to contact Vickie Kunz at the MHA by June 30 regarding issues identified. The CMS will accept comments through July 10. The agency has waived the typical timeline, which requires release of a final rule by Aug. 1. Due to the pandemic, the CMS can provide as few as 30 days between release of the final rule and the Oct. 1 effective date. Members with questions should contact Vickie Kunz at the MHA.

Tags: proposed rule, CMS, LTCH, PPS, Vickie Kunz, FY 2021

Posted in: Member News

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