CHA News Article

CMS Issues IRF, SNF PPS Final Rules

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. 

SNFs will receive an estimated 1.3 percent increase ($470 million) relative to FFY 2013 under the SNF final rule. CMS also finalizes a proposal to add an item to the Minimum Data Set to record the number of distinct calendar therapy days provided to a beneficiary over the seven-day look-back period. 

CHA will issue detailed summaries of the final rules in the coming weeks. Copies of both rules are available below.