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Written by: Mediware on Monday, July 16, 2012 Posted in: Inpatient Rehab

Although IRF did not have its own proposed rule this year, don’t be alarmed when you find out there really was proposed rule information released for IRFs!  ”Where?” you may ask. The Hospital Outpatient Prospective and Ambulatory Surgical Center Payment Systems Proposed Rule is where! That rule included Quality Reporting Programs and decided it was a good place to include IRF comments as well. Many IRFs may ignore released proposed rules on these service areas, but this year, let’s pay attention.

Only July 6, 2012, CMS released the 2013 OPPS/ASC proposed rule (CMS-1589-P). This proposal included comments for the IRF Quality Reporting Program in the event you don’t scan rules that normally do not pertain to your book of business.

Not to be alarmed, nothing significantly changes from what we have prepared to begin this October, but it’s worth mentioning should you want to contribute your thoughts during the comment period that ends at 5:00 p.m. EST on September 4, 2012.  Comments can be made at:, under the “submit a comment” section.

Staring on page 519 of this released proposed rule, you will see section XVII. This section covers the IRF Quality Reporting Program updates. CMS provides rationale and discussion for why this released proposal has commented on IRF regulations in an unsuspecting place.

“XVII: Proposed Inpatient Rehabilitation Facility (IRF) Quality Reporting Program Updates

A. Overview
In accordance with section 1886(j)(7) of the Act, as added by section 3004 of the
Affordable Care Act, the Secretary established a quality reporting program (QRP) for
Inpatient Rehabilitation Facilities (IRFs). The IRF Quality Reporting Program
(IRF QRP) was implemented in the FY 2012 IRF PPS final rule (76 FR 47836). We refer
readers to the FY 2012 IRF PPS final rule (76 FR 47873 through 47883) for a detailed
discussion on the background and statutory authority for the IRF QRP.
In this proposed rule, we are proposing to:

  • (1) adopt updates on a previously adopted measure for the IRF QRP that will affect annual prospective payment amounts in FY 2014;
  • (2) adopt a policy that would provide that any measure that has been adopted for use in the IRF QRP will remain in effect until the measure is actively removed,suspended, or replaced; and
  • (3) adopt policies regarding when notice-and-comment rule-making will be used to update existing IRF QRP measures.

While we generally would expect to publish IRF QRP proposals in the annual IRF
Prospective Payment System (PPS) rule, there are no proposals for substantive changes to
the IRF PPS this year, so we are only publishing an update notice. Because full noticeand-
comment rulemaking is required for what we are proposing for the IRF QRP, we
needed to identify an appropriate rulemaking process in which we could insert our IRF
QRP proposals. As this proposed rule was already scheduled to include additional
pay-for-reporting proposals for the Hospital OQR Program and quality reporting
requirements for the ASCQR Program, it offered an opportunity to allow the public to
review all three quality programs’ proposals in concert with one another in a timeframe
that would be appropriate for implementing these IRF QRP proposals in time for the FY
2014 IRF PPS payment cycle. Therefore, we elected to include the IRF QRP proposals
in this CY 2013 OPPS/ASC proposed rule.”

I propose you read this proposal today! As we await a late July or early August release of notice for 2013, join me for our webinar on August 16 as I discuss IRF PPS FY 2013 Updates and Changes with AMRPA’s Ms. Carolyn Zollar, J.D., Vice President for Government Relations and Policy Development.

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