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CMS Releases Inpatient Rehabilitation Facility Payment Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on April 12 proposing updates to Medicare payment policies and rates for facilities under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program (QRP) for fiscal year (FY) 2022.

For FY 2022, CMS is proposing to update the IRF PPS payment rates by 2.2% .In addition, the proposed rule contains an adjustment to the outlier threshold to maintain outlier payments at 3.0% of total payments. This adjustment would result in a 0.3 percentage point decrease in outlier payments. CMS estimates that the overall increase to IRF payments for FY 2022 would be 1.8% (or $160 million), more than payments in FY 2021.

CMS is also proposing updates to the Inpatient Rehabilitation Facility Quality Reporting Program (IRF QRP). The IRF QRP is a pay-for-reporting program. IRFs that do not meet reporting requirements are subject to a two-percentage point (2.0%) reduction in their Annual Increase Factor. CMS is proposing to adopt one measure. CMS is also proposing a modification to the public reporting of IRF quality measures as well as seeking comment on two Requests for Information (RFI).

CMS is proposing the adoption of the COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) Measure to require IRFs to report COVID-19 HCP vaccinations in their facilities. This proposed measure is designed to assess whether IRFs are taking steps to limit the spread of COVID-19 among their HCP, reduce the risk of transmission within their facilities, and help sustain the ability of IRFs to continue serving their communities through the public health emergency and beyond.

For the two RFIs, CMS is first seeking feedback on ways to attain health equity for all patients through policy solutions. With this RFI, CMS is also seeking comment on the possibility of expanding measure development and the collection of other standardized patient assessment data elements (SPADEs) that address gaps in health equity in the IRF QRP. In the other RFI, CMS is seeking feedback on our future plans to define digital quality measures (dQMs) for the IRF QRP. CMS also is seeking feedback on the potential use of FHIR for dQMs within the IRF QRP, aligning where possible with other quality programs.

Comments must be made to CMS by June 7, 2021.

The proposed rule is available here.

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