Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare
It’s that time of year again – payment updates and proposed rules.
On March 31, 2022, CMS issued the FY2023 PPS proposed rule for IRF and updates to the IRF QRP. This link is to the 123-page unpublished PDF version that will be published in the Federal Register on Wednesday, April 6, 2022.
CMS also issued a Fact Sheet on March 31, 2022.
“For FY 2023, CMS is proposing to update the IRF PPS payment rates by 2.8% based on the IRF market basket update of 3.2% less a 0.4 percentage point productivity adjustment. CMS is proposing that if more recent data become available (for example, a more recent estimate of the market basket update or productivity adjustment), we would use these data, if appropriate, to determine the FY 2023 market basket update and the productivity adjustment in the final rule. In addition, the proposed rule contains an adjustment to the outlier threshold to maintain outlier payments at 3.0% of total payments. This adjustment will result in a 0.8 percentage point decrease in outlier payments. We estimate that overall IRF payments for FY 2023 would increase by 2.0% (or $170 million) relative to payments in FY 2022.”
Additionally, the proposed IRF rule (and the Fact Sheet) speaks to:
- Proposed Permanent Cap on Wage Index Decreases
- Soliciting Comments on the Office of Inspector General (OIG) Recommendation to Include Home Health in the IRF Transfer Policy
- Soliciting Comments on the Methodology for Updating the Facility-Level Adjustment Factors (specifically, the rural, low-income, and teaching status adjustments)
- IRF Teaching Status Adjustment Policy
- Quality Data Reporting on all IRF Patients Regardless of Payer
- Inclusion of the National Healthcare Safety Network (NHSN) Healthcare-associated Clostridioides difficile (C. difficile) Infection Outcome Measure in the IRF QRP – Request for Information (RFI)
- Overarching Principles for Measuring Equity and Healthcare Quality Disparities Across CMS Quality Programs – Request for Information (RFI)