CMS Releases IRF PPS Final Rule for FY 2014.

The Centers for Medicare & Medicaid Services (CMS) recently issued a Prospective Payment System (PPS) final rule updating payment rates for inpatient rehabilitation facilities (IRFs) for fiscal year (FY) 2014.  CMS estimated that the overall economic impact of this final rule is $170 million in increased Medicare payments to IRFs during FY 2014.  The final rule also:

• Revises the list of diagnosis codes that may be counted towards an IRF’s “60 percent rule” to determine “presumptive compliance.”
• Updates the IRF facility-level adjustment factors using an enhanced estimation method.
• Revises sections of the IRF-Patient Assessment Instrument.
• Revises requirements for acute care hospitals that have IRF units.
• Clarifies the regulation text regarding limitation of review.
• Updates quality measures and reporting requirements under the IRF quality reporting program.

 The FY 2014 IRF payment rate update will be effective on October 1, 2013.

 The final rule is available at:

http://www.gpo.gov/fdsys/pkg/FR-2013-08-06/pdf/2013-18770.pdf.

The related CMS fact sheet on the final rule is available at:

http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-Sheets/2013-Fact-Sheets-Items/2013-07-31-2.html.

Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2014; Rules, 78 Fed. Reg.  151, 47860, 47860 (Aug. 6, 2013).

Centers for Medicare & Medicaid Services.  “Fiscal Year 2014 Payment and Policy Changes for Medicare Inpatient Rehabilitation Facilities.”  Fact Sheet.  31 Jul. 2013. 

About the Author

Jennifer Kirchner is a licensed attorney in Illinois and Wisconsin. Ms. Kirchner has expertise in assessing provider compliance with the Anti-Kickback Statute, Stark Law, the False Claims Act, HIPAA Privacy and Security Rules and clinical research laws and regulations.