In accordance with the 2015 Medicare Access and CHIP Reauthorization Act, payment rates for both settings will see a 1% update over FY 2017 rates.
For IRFs, this represents a $75 million increase while SNFs will receive an increase of $370 million. Regarding the IRF presumptive test for demonstrating 60% Rule compliance, CMS has finalized some of the changes as proposed (such as the major multiple trauma codes), modified the original proposal for others (such as the traumatic brain injury and hip fracture codes), and withdrawn some proposed changes (such as for "unspecified codes" and "G72.89-Other specified myopathies"). CMS did not finalize the removal of any codes that count under the presumptive methodology.
CMS also finalized its proposal to eliminate the 25% penalty levied on late patient assessment reports. And in response to concerns by the AHA and other stakeholders, the agency did not finalize the addition of several new standardized patient assessment data elements to the IRF and SNF quality reporting programs.
CMS did finalize its proposals to revise the current quality measure related to pressure ulcers and to remove the all-cause unplanned readmission measure from both QRPs, and also finalized proposals regarding program logistics for the SNF Value-Based Purchasing program.
The rules will take effect Oct. 1. AHA members will receive a Special Bulletin with more information, as well as invitations to national member calls to review the rules.