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Proposed PPS Rules for Post-Acute Care Settings Released

May 26, 2017

The federal Centers for Medicare and Medicaid Services (CMS) has issued proposed rules for fiscal year 2018 for three post-acute care settings: long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs). The proposed rules update the prospective payment systems (PPSs) for these facilities for 2018 and make additional regulatory changes. Highlights of the LTCH rule can be found on the WHA website at www.wha.org/medicare.aspx.

Major highlights of the IRF proposed rule include a one percent market basket update; an increase in the high-cost outlier threshold; elimination of the 25 percent penalty for late IRF patient assessment instrument (PAI) submittals; expanding PAI reporting requirements; and refinement of the codes used to assess an IRF’s compliance with the “60% rule” (which requires no less than 60 percent of the IRF’s patient population to be treated for one of 13 conditions that typically require intensive rehabilitation therapy).

Major highlights of the SNF proposed rule include a one percent payment update; addition of four outcome measures on resident functional status to the Quality Reporting Program for FY 2020; basing potentially preventable 30 days post-discharge readmission measure on two years of data rather than one year; requiring reporting of certain standardized patient assessment data starting in FY 2019; and adjusting the scoring methodology for awarding value-based purchasing incentive payments. 

Comments on the LTCH PPS proposed rules are due to CMS by June 13, while comments on the IRF and SNF PPS proposed rules are due June 26. WHA is reviewing these rules in advance of those deadlines and will be submitting comments. If you have any questions or feedback on these proposed rules, contact Laura Rose, WHA vice president, policy development, at lrose@wha.org
 

This story originally appeared in the May 26, 2017 edition of WHA Newsletter