2020 PROPOSED RULES INPATIENT REHAB

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

CMS Issues Proposed Inpatient Rehabilitation Facility FY 2020 PPS Update

The Centers for Medicare and Medicaid Services (CMS) have released a proposed rule that would update the payment rates and quality reporting items for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2020.

The proposed rule includes the classification and weighting factors for the IRF PPS’s case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2020. This proposal would also rebase and revise the IRF market basket to reflect a 2016 base year, rather than the current 2012 base year.

Additionally, the proposed rule would replace the previously finalized unweighted motor score with a weighted motor score to assign patients to CMGs and remove one item from the score beginning in FY 2020 and to revise the CMGs and update the CMG relative weights and average length of stay values beginning with FY 2020, based on analysis of 2 years of data (FY 2017 and FY 2018).

CMS is also proposing to update the IRF wage index to use the concurrent IPPS wage index for the IRF PPS beginning with FY 2020. Currently, CMS uses wage index data from the prior year.

The 274-page document is scheduled for publication in the Federal Register on April24th. A copy is currently available at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2019-07885.pdf. This link will change upon publication. A 60-day comment period ending June 19th is provided.

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