Medical rehabilitation focuses on improving or restoring functional independence for individuals with disabilities resulting from injury, illness or a medical condition.
Medical rehabilitation is provided at all levels of the health care continuum, including general acute-care hospitals, inpatient rehabilitation facilities (IRFs), skilled-nursing facilities, long-term-care hospitals, outpatient programs and home health agencies.
The Centers for Medicare & Medicaid Services (CMS) has updated its frequently asked questions (FAQs) document regarding therapy services functional reporting. The document, attached, provides information about CMS coverage for physical therapy, occupational therapy, and speech/language pathology services.
The Centers for Medicare & Medicaid Services (CMS) is seeking input from inpatient rehabilitation facilities (IRFs) and long-term care hospitals (LTCHs) regarding implementation of new quality reporting programs (QRPs) for those settings. On behalf of CMS, Health Care Innovation Services is requesting that IRF and LTCH providers participate in brief interviews to help better understand the burdens imposed on providers, how providers ensure accuracy of data, how the QRP has impacted patient services and outcomes, and what CMS can do in the future to improve the program and processes.
Interviews will be conducted by telephone, and reports or supplemental documents submitted to CMS will not link specific answers to any specific providers. Anyone interested in participating for either the IRF or the LTCH QRP should contact Pat Hanson at firstname.lastname@example.org.
The U.S. House of Representatives Ways and Means Committee has released draft legislation that includes several provisions affecting payment policy for post-acute care (PAC) services. The committee held a hearing on the topic on June 14.
The latest legislative proposals mirror PAC proposals put forth by President Obama in his FFY 2014 budget, as well as discussions by Simpson-Bowles and the Bipartisan Policy Commission. The committee’s draft legislation specifically addresses the following changes:
Reducing market basket updates for home health agencies, skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs) and long-term care hospitals;
Creating site-neutral payments between IRFs and SNFs for certain procedures;
Modifying the criteria required for IRF status (the so-called “75 percent rule”);
The Centers for Medicare & Medicaid Services (CMS) has issued the final rules for the inpatient rehabilitation facility (IRF) and skilled-nursing facility (SNF) prospective payment systems (PPS) for federal fiscal year (FFY) 2014. Provisions of the final rules go into effect Oct. 1.
Under the IRF final rule, CMS estimates that payments to IRFs will increase by 2.3 percent. In an improvement over the proposed rule, CMS makes some changes to its proposal to update the list of codes that may count toward an IRF’s “60 percent rule” compliance assessment using the presumptive test. CMS will remove fewer codes than originally proposed, and the shortened list of eligible codes will not take effect for one year. CMS also finalizes proposals and adds several new measures to the IRF Quality Reporting Program, and makes changes to the IRF patient assessment instrument.
The Centers for Medicare & Medicaid Services (CMS) has published a new frequently asked questions (FAQ) document on the functional reporting requirements for Part B physical therapy, occupational therapy and speech/language pathology services.
Outpatient therapy providers were required to initiate reporting on the functional limitation and associated severity of the limitation on claims beginning Jan. 1. Effective July 1, submitted claims that do not include G codes representing the functional limitation and severity modifier will be returned to the provider but can be resubmitted with the information included. A copy of the current FAQ document is attached.
Recordings of recent conference calls held by the Centers for Medicare & Medicaid Services on the quality reporting programs for inpatient rehabilitation facilities (IRFs) and long-term-care hospitals (LTCHs) will be available July 30 through Aug. 1. Facilities may access the calls by dialing (855) 859-2056, and using conference IDs 13189170 for IRFs and 13198135 for LTCHs. As mandated by the Affordable Care Act, IRF and LTCH quality reporting programs will begin Oct. 1.
The Centers for Medicare & Medicaid Services (CMS) will host a series of monthly Open Door Forum (ODF) calls for the upcoming implementation of the inpatient rehabilitation facility quality reporting program. The calls will be held from 10 a.m. to 11:30 a.m. (PT) July 26, Aug. 16, Sept. 20 and Oct. 18, and will include presentations on various topics with opportunities for questions and answers. Providers may submit topic suggestions to IRF.questions@CMS.hhs.gov. For more information, go to www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/index.html.
The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule regarding the inpatient rehabilitation facility (IRF) quality reporting program (QRP). The proposed rule was included in the calendar year 2013 hospital outpatient prospective payment system (OPPS) proposed rule issued July 6. CHA’s “first-glance” summary of the OPPS and IRF QRP proposed rules is available at www.calhospital.org/cy2013-opps-proposed-first-glance. In the coming weeks, CHA will issue a more detailed summary of the proposed rule, and will work with members to develop comments for submission to CMS. Comments are due Sept. 4 at 2 p.m. (PT).