2018 final RULES INPATIENT REHAB

An Analysis and Commentary on Federal Health Care Issues by Larry Goldberg

CMS Finalizes Inpatient Rehabilitation Facility FY 2018 PPS Update.

The Centers for Medicare and Medicaid Services (CMS) have published a final rule to update the payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2018.

The rule also (1) revises the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnosis codes that are used to determine presumptive compliance under the “60 percent rule,”
(2) removes the 25 percent payment penalty for inpatient rehabilitation facility patient assessment instrument (IRF-PAI) late transmissions,
(3) removes the voluntary swallowing status item (Item 27) from the IRFPAI,
(4) summarizes comments regarding the criteria used to classify facilities for payment under the IRF PPS,
(5) provides for a subregulatory process for certain annual updates to the presumptive methodology diagnosis code lists,
(6) adopts the use of height/weight items on the IRF-PAI to determine patient body mass index (BMI) greater than 50 for cases of single-joint replacement under the presumptive methodology, and
(7) revises and updates measures and reporting requirements under the IRF quality reporting program (QRP).

The 241-page document is scheduled for publication in the Federal Register on August 3rd. A copy is currently available at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2017- 16291.pdf. Of course, this link will change upon publication. The August 3rd Federal Register site will be: https://www.federalregister.gov/documents/2017/08/03/2017-16291/medicare-program-inpatientrehabilitation-facility-prospective-payment-system-for-federal-fiscal.

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