2021 PROPOSED RULES INPATIENT REHAB

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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