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CMS Issues FFY 2022 Inpatient Rehabilitation Facility PPS Final Rule

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The Centers for Medicare & Medicaid Services (CMS) has issued the federal fiscal year (FFY) 2022 inpatient rehabilitation facility (IRF) prospective payment system final rule updating payment policies and rates. The final rule is effective Oct. 1.  

CMS finalizes an annual payment update of 1.9% that includes a market-basket update of 2.6%, with a 0.7 percentage point productivity adjustment. These payment adjustments, in addition to other changes in the rule, are estimated to result in an overall increase of 1.5% for IRF payments, or approximately $130 million compared to FFY 2021. 

In addition to the annual payment updates, key proposals and feedback on two requests for information (RFI) are highlighted below:   

  • COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) Measure: CMS finalizes the adoption of a new measure that requires IRFs to report COVID-19 HCP vaccinations in their facilities beginning with the FFY 2023 IRF quality reporting program (QRP). 
  • Transfer of Health (TOH) Information to the Patient-Post Acute Care (PAC) Quality Measure: CMS updates this quality measure by removing patients discharged home under the care of an organized home health service organization or hospice from the definition of the denominator for the TOH Information to the Patient–PAC measure beginning with FFY 2023.
  • Public Reporting of Quality Measures Impacted by COVID-19 Public Health Emergency (PHE) Exemptions: To account for COVID-19 PHE exceptions to IRF QRP reporting requirements for Q1 and Q2 2020, CMS will calculate IRF QRP measures using three quarters (Q3 2020 through Q1 2021) of data for assessment-based measures, and six quarters for claims-based measures.    
  • RFI on Closing the Health Equity Gap: The proposed rule solicited feedback on ways to improve health equity for all patients. The comments CMS received will be taken into consideration as the agency works to develop policies to improve health equity. CMS plans to provide additional stratified quality measure information to providers related to race and ethnicity. 
  • RFI on Digital Quality Measurement in PAC Quality Reporting Programs: CMS will consider the feedback received on the agency’s plans to define and develop digital quality measures (dQMs) for the IRF QRP, including the use of fast health care interoperability resources to support digital quality measures, as the agency develops future policies and continues to work with other agencies and stakeholders to coordinate and to inform the transformation to dQMs leveraging health IT standards.
  • Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Policy: CMS finalizes exclusions to the fee schedule amounts for wheelchair accessories (including seating systems) and seat and back cushions furnished in connection with certain complex rehabilitative power and manual wheelchairs from adjustments based on information from the DMEPOS Competitive Bidding Program.

Additional information is available in a CMS fact sheet.