CMS finalizes payment and quality rules for post-acute providers

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The Centers for Medicare & Medicaid Services (CMS) recently issued three final rules outlining 2018 Medicare payment rates for skilled nursing facilities, hospice, and inpatient rehabilitation facilities.  The final rules are effective for fiscal year (FY) 2018.

The 2018 Skilled Nursing Facility (SNF) Prospective Payment System Final Rule:

  • increases Medicare payment rates by 1.0 percent for FY 2018
  • revises and rebases the SNF market basket index by updating the base year data from FY 2010 to 2014
  • finalizes updates to the SNF Quality Reporting Program, including replacing the pressure ulcer measure with an updated version, adopting new functional status measures and publicly displaying new measures
  • finalizes
  • finalizes policies for the SNF Value-Based Purchasing Program for FY 2019 and the requirements regarding the composition of professionals for the survey team

The 2018 Hospice Final Rule:

  • updates FY 2018 Medicare payment rates by 1.0 percent and the wage index for hospices serving Medicare beneficiaries and hospice quality reporting requirements
  • includes a statutory aggregate cap limiting the overall payments made to a hospice annually
  • finalizes eight measures from the CAHPS® hospice survey data already submitted by hospices
  • sets out requirements for CAHPS® survey for 2020 through 2022
  • finalizes CMS policies associated with public reporting of hospice data, effective August 2017 via a Hospice Compare Site

The 2018 Inpatient Rehabilitation Facility (IRF) Prospective Payment System Final Rule:

  • updates payment rates for FY 2018 to reflect a 1.0 percent increase factor
  • finalizes the removal of the 25 percent payment penalty in order to remove an unnecessary burden on IRFs
  • finalizes the replacement of the current pressure ulcer measure with an updated version of that measure, the removal of the All-Cause Unplanned Readmission Measure for 30 Days Post-Discharge from IRFs, and the public display of six additional quality measures
  • does not finalize CMS’ proposed removal of certain ICD-10-CM codes from the presumptive methodology, with continued monitoring to occur