Mediware Rehabilitation Blog
It's Oct. 1, 2014, and that signals a fiscal year for Inpatient Rehabilitation Facilities. The 2015 Final Rule is now in place and the changes that come with this date begin with all discharges beginning today (10/1/14).
Let's revisit some helpful LINKS and information so that you can check off your list of things to do beginning now!
Inpatient Rehabilitation as a specialty is being challenged more each day for the care and skills uniquely provided in the IRF/U environment. Continuing to defend the highly individualized and specific skill sets of patients that enter IRF somehow are not apparent because 'Rehabilitation' as a word has been highly generic in terms of explaining recovery for just about any impairment. CARF certification standards certainly demonstrate that the basic expectations for a rehabilitation level of care are highly unique, individualized and specialized for the patient population treated; each year CARF provides opportunities for comment on new standards. An invitation just arrived. Please be a part of this review!
90 percent seems like a good number unless it's 90 percent incorrect. Recently, CMS hired Strategic Health Solutions as their Supplemental Medical Review Contractor (SMRC) to look at IRF/U documentation and see if it was meeting the required medical necessity documentation and regulatory requirements. Unfortunately, the findings were not in favor of payment. Let's look at what they discovered. If you haven't heard it loud and clear you MUST audit your own records for the appropriate elements of charting or you too could be in the risk pool for non-payment.
If you were a part of this initial review, AMRPA would like to speak to you!
Each year the IRF final rule publishes the 2 percent reduction amount in the standard payment rate that will take affect for the present fiscal year as it relates to submission of quality indicator information received or not received in the fiscal year from two cycles prior. Reductions in the standard payment would be applied in the 2015 fiscal year for those not participating in ALL indicators from 2013. 2014 submissions will affect 2016 payment year, 2015 will affect 2017 payment year, etc.
CMS just released an announcement for the deadline of 2014 first quarter data. Here are the facts, links and helpful numbers so that YOU can stay ahead of the transmission deadlines and not be affected in the 2016 payment cycle.
The IRF Proposed Rule this spring held many changes, so many in fact facilities were wondering if they had the time to educate and be ready for the 2015 payment year. In the Final Rule there were several surprises. Did Medicare realize the overwhelming number of changes may be a bit too much? Perhaps, but whatever the final reason, some changes are on hold until next year's cycle.
Here is a summary of those items that will stay and those that will wait just a bit longer!
3 Hour Rule continues to be a main defining factor that CMS has set as the 'threshold' to determine if the patient in an IRF/U receives an intensity of therapy services specific to an acute rehabilitation level of necessity. In this blog, respondents to a 3 Hour Rule survey share information and details on the 3 Hour Rule as operationalized in their facilities.