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CMS Delivers FY 2018 Final Rule for IRF and SNF

Written by: Mediware Bloggers on Thursday, August 17, 2017 Posted in:

cms final rule 2018

The final changes are much like those proposed earlier this year.

On July 31, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a final rule outlining fiscal year (FY) 2018 Medicare payment policies and rates for the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) and the IRF Quality Reporting Program (IRF QRP). The changes, which were mostly addressed in the proposed rule, will affect all IRF discharges on or after October 1, 2017.

Here are a few of the key elements of the FY 2018 final rule.

1. Payment rates updated.

CMS will implement a 1% market basket increase but, because of an approximate .1% decrease to aggregate payments due to updates to the outlier threshold, the overall estimated update for FY 2018 is approximately 0.9 percent.

2. No more penalty for late IRF-PAI transmissions.

The 25% payment penalty will no longer be assessed.

3. ICD-10 lists for presumptive methodology refined but none deleted.

Diagnosis codes for both traumatic brain injury and hip fracture will count toward IRF presumptive compliance as will two or more of the three major multiple trauma codes from the lists (in the specified code combinations)

4. Swallowing status removed from IRF-PAI.

Item #27, which was duplicated by an item in the “quality indicators” section, was removed.

5. BMI calculated using data from the IRF-PAI.

For cases of lower extremity single joint replacement, the BMI calculation that determines whether each case counts toward presumptive compliance percentage will now use patient height and weight data collected in the IRF-PAI.

For additional details, review the “Final Fiscal Year 2018 Payment and Policy Changes for Medicare Inpatient Rehabilitation Facilities” Fact Sheet.

While this year’s final rule doesn’t involve drastic changes, the proposed rule for FY 2019 includes many more. That’s why you need a software solution designed specifically for inpatient and outpatient rehab, such as MediLinks, which can help you more easily manage the burden of CMS regulations.

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