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

CMS Proposes Inpatient Rehabilitation Facility FY 2021 PPS Update

The Centers for Medicare and Medicaid Services (CMS) have released a proposed rule to update the inpatient rehabilitation facility payment amounts for 2021.

The proposal includes the classification and weighting factors for the IRF PPS’s case-mix groups (CMGs), and adoption of the most recent Office of Management and Budget (OMB) statistical area delineations. CMS would apply a 5.0 percent cap on any wage index decrease compared to FY 2020 in a budget neutral manner.

CMS is proposing to amend the IRF coverage requirements to remove the post-admission physician evaluation requirement and codify existing documentation instructions and guidance.

Further, CMS is proposing to amend the IRF coverage requirements to allow non-physician practitioners to perform certain requirements that are currently required to be performed by a rehabilitation physician.

There are no proposals or updates to the IRF Quality Reporting Program (QRP).

The 97-page document is scheduled for publication in the Federal Register on April 21. A copy is currently available at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2020-08359.pdf This link will change upon publication. A 60-day comment period ending June 15 is provided.

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