CMS to hike inpatient rehab payment rates

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The Centers for Medicare & Medicaid Services (CMS) issued a final rule July 29, which increases Medicare payment rates for more than 1,200 inpatient rehabilitation facilities (IRFs) by 2.2 percent in fiscal year 2012. CMS projects an increase of $150 million in payments during the first year as a result of the rule, which would also institute new reporting requirements for the facilities.

Under the rule, IRFs will submit data on two quality measures: a urinary catheter-associated urinary tract infection measure and a pressure ulcers measure, according to CMS. A third measure­—“30-day Comprehensive All Cause Risk Standardized Readmission”—is also under development for future implementation. IRFs that do not submit performance data will have their payments reduced by 2 percent beginning in fiscal year 2014, according to CMS.

Eventually, the agency also plans to establish a process to make that data available to the public. “The final rule extends to the Inpatient Rehabilitation Facility payment system a quality reporting program designed to encourage these facilities to adopt practices that will better protect patient safety and prevent hospital-acquired conditions, which is an essential part of providing well-coordinated patient-and-family-centered care,” said CMS Administrator Donald M. Berwick, MD.

The final rule will affect payments to more than 200 freestanding rehabilitation hospitals and more than 1,000 IRF units in acute care hospitals and critical access hospitals, beginning with discharges on or after Oct. 1, according to CMS. The rule can be found at the Office of the Federal Register’s Public Inspection Desk and was published Aug. 5 in the Federal Register

“The final rule we are announcing today will help ensure that Medicare beneficiaries who require rehabilitation in an inpatient setting, continue to have access to high quality care that will help them meet their rehabilitation goals during the difficult work of recovery,” said Berwick.