CMS issues LTCH PPS proposed rule for FY 2018

Apr 14, 2017 - 05:26 PM

The Centers for Medicare & Medicaid Services late today issued its long-term care hospital prospective payment system proposed rule for fiscal year 2018. Under the proposed rule, traditional LTCH PPS rates would increase by a net of 0.4%, while payment rates for site-neutral cases would decrease by a net of 22%. After accounting for all the rule’s provisions, LTCH payments are estimated to decrease by 3.75% ($173 million) compared to FY 2017 payment levels. In addition, during FY 2018, CMS proposes a regulatory moratorium on the 25% Rule so that it can evaluate whether the policy is still needed; this proposal would increase payments by $65 million. “Today’s rule outlines some promising proposals intended to reduce regulatory barriers for hospitals, health systems and the patients they serve,” said AHA Executive Vice President Tom Nickels. “Specifically, we are extremely pleased with the proposed regulatory moratorium on the implementation of the 25% Rule for long-term care hospitals that will allow CMS time to determine if the policy is still necessary.” In addition, CMS proposes to pay all short-stay outlier cases a graduated per diem that blends the IPPS and LTCH amounts to remove the financial incentive to delay discharge. The rule also proposes a number of changes to the FY 2020 LTCH Quality Reporting Program. Specifically, the agency would add measures assessing pressure ulcer changes, compliance with a spontaneous breathing trial, and ventilator liberation rates. CMS also proposes to remove an existing pressure ulcer measure, and a measure assessing all-cause readmissions within 30-days of LTCH discharge. In addition, CMS would require LTCHs to collect certain standardized patient assessment data beginning with LTCH admissions on or after April 1, 2018 to meet the requirements of the Improving Medicare Post-Acute Care Transformation Act of 2014. The proposed rule will be published in the April 28 Federal Register and comments will be accepted through June 13. AHA members will receive a Special Bulletin with further details. 

Related News Articles

Perspective
Perspective: Gearing up for a busy September on Capitol Hill
Two weeks ago, I wrote about the
Headline
Appeals court reverses decision voiding CMS rule on Medicaid DSH audits
The U.S. Court of Appeals for the District of Columbia Circuit reversed the voiding of a rule that included Medicare and private insurance payments when…
Headline
AHA supports bill to improve MA plans’ prior authorization process
The AHA today voiced support for the Improving Seniors’ Timely Access to Care Act (H.R. 3107), bipartisan legislation that would establish requirements for the…
Headline
Medicare issues final decision covering certain CAR T-cell therapies
Medicare will cover nationally Chimeric Antigen Receptor T-cell therapies approved by the Food and Drug Administration to treat certain cancers, as well as off…
Headline
Study: Half of rural hospitals could close under Medicare public option
Offering a government insurance program reimbursing at Medicare rates as a public option on the health insurance exchanges could place as many as 55% of rural…
Headline
CMS discontinues Medicare Advantage demonstration for clinicians
The Centers for Medicare & Medicaid Services will discontinue the Medicare Advantage Qualifying Payment Arrangement Incentive Demonstration due