CMS Releases IRF FY 2017 Proposed Rule

May 4, 2016
Rick Gawenda

On April 21, 2016, the Centers for Medicare and Medicaid Services (CMS) released FY 2017 Inpatient Rehabilitation Facility (IRF) proposed rule. In the proposed rule, CMS is proposing to increase IRF payment by 1.45% in FY 2017 compared to FY 2016.

Beginning in FY 2014, any IRF that does not submit the required data to CMS receives a 2.0 percentage point decrease in its annual increase factor for payments under the IRF PPS. The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) requires the continued specification of quality measures, as well as resource use and other measures, for the IRF QRP.

In order to satisfy the requirements of the IMPACT Act, CMS is proposing four claims-based measures for inclusion in the IRF QRP for the FY 2020 and FY 2018 payment determination and subsequent years and one new assessment-based quality measure for inclusion in the IRF QRP for FY 2020 and subsequent years, respectively:

Discharge to Community – Post Acute Care (PAC) IRF QRP (claims-based);
Medicare Spending Per Beneficiary (MSPB) – Post-Acute Care (PAC) IRF QRP (claims-based);
Potentially Preventable 30 Day Post-Discharge Readmission Measure for IRFs (claims-based);
Potentially Preventable Within Stay Readmission Measure for IRFs (claims-based); and
Drug Regimen Review Conducted with Follow-Up for Identified Issues (assessment-based).

Pending final data analysis, CMS is also proposing to add four new measures to IRF QRP public reporting on a CMS website, such as Hospital Compare, by Fall 2017.  In addition, we propose to extend the timeline for submission of exception and extension requests for extraordinary circumstances from 30 days to 90 days from the date of the qualifying event.

CMS will accept comments on the proposed rule until June 20, 2016. To access the proposed rule, click HERE. To access the CMS IRF fact sheet on the proposed rule, 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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