CMS issued final rules July 31 that increase payments to inpatient rehabilitation facilities and skilled-nursing facilities by $925 million.
Here are six things to know about the rules:
Inpatient rehabilitation facility payment rule
1. Under the final Inpatient Rehabilitation Prospective Payment System rule, net payments will increase by 1.3 percent, or $105 million, in fiscal year 2019, which begins Oct. 1, 2018.
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2. The final rule permits rehabilitation physicians to lead interdisciplinary team meetings remotely without any additional documentation requirements, and removes the admission order documentation requirement.
3. Under the final rule, the post-admission physician evaluation will count as one of the face-to-face physician visits required in the first week of the IRF admission.
Skilled-nursing facility payment rule
4. CMS’ final rule for skilled-nursing facilities increases payments by 2.4 percent, or $820 million, in fiscal year 2019.
5. The rule finalizes the implementation of a new Patient-Driven Payment Model, which uses ICD-10 diagnosis codes and other factors as the basis for patient classification and payment. This is a departure from the reliance on using the volume of services to set payments. “The new model is designed to improve the incentives to treat the needs of the whole patient, instead of focusing on the volume of services the patient receives, which requires substantial paperwork to track over time,” CMS said in a fact sheet for the final rule.
6. The rule finalizes several changes to the SNF Value-Based Purchasing Program, including an adjustment to the program’s scoring methodology and an extraordinary circumstances exemption policy.
Date: August 3, 2018