CMS urged to address case-mix grouping concerns in PAC proposed rules

AHA today urged the Centers for Medicare & Medicaid Services to address in forthcoming rules for inpatient rehabilitation facilities and other post-acute care providers several concerns related to the agency’s revised case-mix grouping system for IRFs. CMS finalized in its fiscal year 2019 final rule for the IRF prospective payment system a proposal to reform how IRF patients are assigned to case-mix groups starting in FY 2020. AHA asks CMS to provide additional insight into the policy change, and to analyze how the new case-mix groupings will affect patients and efforts to create a unified PAC payment system. The association also reiterates its concerns with certain functional assessment data elements and requests transparency in the forthcoming proposed rules for all PAC settings.