CMS proposes several rules that in fiscal year 2015 would affect payment policies and rates for various providers

In the past few days, the Centers for Medicare & Medicaid Services (“CMS”) has published several proposed rules that would affect payment policies and rates in fiscal year (“FY”) 2015 for inpatient rehabilitation facilities, inpatient psychiatric facilities, and skilled nursing facilities.

Under the proposed rule for inpatient rehabilitation facilities (“IRFs”), Medicare payments to IRFs are projected to increase an estimated $160 million in FY 2015. CMS would freeze the facility-level adjustment factors. In the proposed rule, CMS also discusses the transition from ICD-9-CM to ICD-10-CM for all diagnosis codes used in the IRF PPS Grouper software and the software for evaluating IRF’s compliance with the 60 percent rule. The proposed rule will be published in the Federal Register on May 7th. Public comments are due to CMS by June 30th. Read the IRF PPS proposed rule.

In the Inpatient Psychiatric Facilities Proposed Payment System (“IPF PPS”) proposed rule, CMS explains that it expects payments to Inpatient Psychiatric Facilities (“IPFs”) to increase by 2.1 percent in FY 2015. CMS also updates the Inpatient Psychiatric Facility Quality Reporting Program (“IPFQR”), which requires IPFs to report on quality measures or incur a reduction in their annual update. The proposed rule would expand the measure sets in future fiscal years and discusses CMS’s plans to better collect data to help target future measures. The proposed rule will be published in the Federal Register on May 6 and CMS will accept comments on the rule until June 30th. Read the IPF PPS proposed rule.

CMS projects that payments to skilled nursing facilities (“SNFs”) would increase two percent, $750 million, in FY 2015 under the SNF proposed rule. CMS in the proposed rule would change the wage index calculation, based on revisions from the Office of Management and Budget regarding an SNF’s urban or rural status. The rule would effectuate changes to therapy levels for patients and also implement ACA provisions related to the use of civil money penalties imposed against nursing homes. Comments on the proposed rule are due to CMS by June 30th. Read the SNF proposed rule.