CMS Releases FY 2019 IRF Proposed Rule

April 30, 2018
Rick Gawenda

On April 27, 2018, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2019 proposed rule for inpatient rehabilitation facilities (IRFs). This proposed rule would update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for FY 2019. As required by the Social Security Act (the Act), this proposed rule includes the classification and weighting factors for the IRF prospective payment system’s (PPS) case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2019. CMS is also proposing to alleviate administrative burden for IRFs by removing the Functional Independence Measure (FIM) instrument and associated Function Modifiers from the IRF Patient Assessment Instrument (IRF-PAI) and revising certain IRF coverage requirements to reduce the amount of required paperwork in the IRF setting. In addition, CMS is soliciting comments on removing the face-to-face requirement for rehabilitation physician visits and expanding the use of non-physician practitioners (that is, nurse practitioners and physician assistants) in meeting the IRF coverage requirements. For the IRF Quality Reporting Program (QRP), CMS is proposing to adopt a new measure removal factor, remove two measures from the IRF QRP measure set, and codify in our regulations a number of requirements.

CMS is accepting comments on this proposed rule until June 26, 2018. To access the proposed rule, click HERE. To access the IRF Fact Sheet, click HERE.

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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.

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