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Written by: Darlene D'Altorio-Jones (1959-2015) on Friday, May 3, 2013 Posted in: Inpatient Rehab

With exactly 60 days to comment before July 1, 2013, CMS released the proposed IRF PPS Rule for fiscal year 2014, which would cover discharges on or after Oct. 1, 2013 – Sept. 30, 2014. The rule is referenced as CMS-1448-P and was filed 05/02/2013  with a to be published date of  05/08/2013.


CMS is proposing robust updates and changes to next years IRF PPS Regulations. In short summary, these are the highlights:

1.) Revise the list of diagnosis codes that are used to determine presumptive compliance under the “60 percent rule.”   (pg 64- 88)

2.) Update the IRF facility-level adjustment factors.  (pg 35)

3.) Revise sections of the Inpatient Rehabilitation Facility-Patient Assessment Instrument that relate to the quality reporting section.  (pg 100)

4.) Revise requirements for acute care hospitals that have IRF units. (pg 96)

5.) Clarify the IRF regulation text regarding limitation of review. (pg185)

6.) Update references to previously changed sections in the regulations text. (pg 95)

7.) Revise and update quality measures and reporting requirements under the IRF quality reporting program, as a recent blog alerted you on the indicators they were reviewing for selection.  (pg 107 & pg 124 starts)

8.) Revise sections of the IRF PAI that are not quality related. Look for additions, deletions, changes in selection items, increased number of co-morbid conditions and a signature and date page.   (pg 88 – 95  & 151)

9.) Applying reduction factors for 2014 if failure to report timely on the previous quality indicators. (pg 142)

As we are reviewing the 186 page document right now, stay tuned for further blog updates and a mid-summer Proposed Rule webinar.  Please be aware that these are proposed regulations and CMS is seeking your comments before the final is released. Pay attention to the very beginning portion of the document and the very end which provide information for where and how to submit your comments for both the rule and the updates proposed to the IRF PAI itself.

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