CMS Releases Inpatient Psychiatric Facility Payment Proposed Rule

For FY 2022, CMS is proposing to update the IPF PPS payment rates by 2.1%. Total estimated payments to IPFs are estimated to increase by 2.3% or $90 million in FY 2022 relative to IPF payments in FY 2021. An additional update to the outlier threshold to hold outlier payments at 2.0% of total payments, will result in a 0.2% overall increase to aggregate payments due to updating the outlier threshold results.

The IPFQR Program requires IPFs to submit quality data to CMS in accordance with the IPFQR Program’s requirements or receive a payment reduction of 2.0 percentage points to their annual update. CMS is proposing to add two new measures and also remove three measures in the IPFQR program. CMS is proposing to add the COVID-19 Vaccination Coverage Among Healthcare Personnel (HCP) measure to the IPFQR Program in FY 2023. The process measure was developed by the Centers for Disease Control and Prevention (CDC) to track COVID-19 vaccination coverage among HCP in the IPF setting. This measure would be reported using the COVID-19 Modules on the CDC’s National Healthcare Safety Network web portal.

CMS is also proposing to add the Follow-up After Psychiatric Hospitalization (FAPH) measure to the IPFQR Program starting in FY 2024.This claims-based measure expands the cohort of the Follow-up After Hospitalization for Mental Illness (FUH) measure, which is currently in the IPFQR Program, to include patients with substance use disorders. CMS plans to remove the FUH measure from the IPFQR Program if the FAPH measure is adopted because the FAPH measure is more broadly applicable to a larger patient population.

CMS is also proposing to remove the Alcohol Use Brief Intervention Provided or Offered and Alcohol Use Brief Intervention, Tobacco Use Treatment Provided or Offered and Tobacco Use Treatment, and Timely Transmission of Transition Record measures from the program.

CMS also included a request for information in the proposed rule, seeking feedback on ways to attain health equity for all patients through policy solutions. Specifically, CMS is requesting comment on future potential stratification of quality measure results by dual eligibility and other social risk factors in facility-specific reports, ways to improve demographic data collection, and the potential creation of a facility equity score to synthesize results across multiple measures and social risk factors.

Comments are due to CMS by June 7, 2021.

The Proposed Rule is available here.