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2018 Proposed Rules Inpatient Rehab

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

CMS Proposes Inpatient Rehabilitation Facility FY 2018 PPS Update

The Centers for Medicare and Medicaid Services (CMS) have published a proposed rule to update the payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2018. The proposed rule would also remove the 25 percent payment penalty for IRF-PAI late transmissions, remove the voluntary swallowing status item (Item 27) from the IRF-PAI, revise the ICD-10-CM diagnosis codes that are used to determine presumptive compliance under the 60 percent rule, provide for automatic annual updates to the presumptive methodology diagnosis code lists, solicit comments regarding the criteria used to classify facilities for payment under the IRF PPS, use height/weight items from the IRF-PAI to determine patient BMI greater than 50 for cases of lower extremity single joint replacement under the presumptive methodology, and revise and update the quality measures and reporting requirements under the IRF QRP.

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