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Written by: Darlene D'Altorio-Jones (1959-2015) on Monday, July 30, 2012 Posted in: Inpatient Rehab

CMS 1433-N was just released last week. For those not versed in the numbers, this is the all important update for inpatient rehabilitation facilities and holds valuable information on regulation and payment for the 2013 fiscal year, beginning Oct. 1, 2012.

No policy changes were proposed in this notice, but that does not mean there is not a significant impact to ongoing IRF management and financial success.  Value changes have been published and are in alignment with 2012 implemented changes.    In essence, “methods described in the FY 2012 IRF PPS final rule (76 FR 47836) to update the Federal prospective payment rates for FY 2013 using updated FY 2011 IRF claims and the most recent available IRF cost report data,”  is how CMS described these updates.  The standard payment conversion factor per 1.0 case mix has moved from $14,076 to $14,343 before applying facility specific adjustment values.

Resulting impact changes for 2013 Notice are:

– Case-Mix Group (CMG) Relative Weights and Average Length-of-Stay Values for FY 2013 updates – create resultant changes in payment values and average stays

– Updates to the Facility-Level Adjustment Factors

– Market Basket Increase Factor, Productivity Adjustment, “Other”Adjustment discussions

– Labor-Related Share for FY 2013

– Area Wage Adjustment

– Description of the IRF Standard Conversion Factor and Payment Rates for FY 2013

– Update to Payments for High-Cost Outliers under the IRF PPS

– Update to the Outlier Threshold Amount for FY 2013

– Update to the IRF Cost-to-Charge Ratio Ceilings

Quality Indicators for Pressure Ulcer & CAUTI, as previously advised, without change in this notice.  Addendum’s will remain on the CMS website, rather than inclusion in the Federal Register when published. The wage index appears as a separate addendum this year.

A quality information proposed-rule-type notice was also released earlier this month in an unsuspecting place. The proposed rule discusses more of the how and why quality indicator changes can be made in the future without any impact to previously published quality guidelines.

AMRPA and Mediware will share the details of this notice release in a few short weeks.  The information and tools can be utilized for impact analysis specific to your book of business.