View Rule

View EO 12866 Meetings Printer-Friendly Version     Download RIN Data in XML

HHS/CMS RIN: 0938-AS09 Publication ID: Fall 2014 
Title: FY 2015 Inpatient Rehabilitation Facility Prospective Payment System (CMS-1608-F) 
Abstract:

This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2015 (for discharges occurring on or after October 1, 2014, and on or before September 30, 2015) as required by the statute. This final rule will also collect data on the amount and mode (that is, Individual, Concurrent, Group, and Co Treatment) of therapy provided in the IRF setting according to therapy discipline, revise the list of diagnosis and impairment group codes that presumptively meet the "60 percent rule" compliance criteria, provide a way for IRFs to indicate on the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) form whether the prior treatment and severity requirements have been met for arthritis cases to presumptively meet the "60 percent rule" compliance criteria, and revise and update quality measures and reporting requirements under the IRF quality reporting program (QRP). The revisions to the list of diagnosis codes that are used to determine presumptive compliance under the "60 percent rule" that were finalized in FY 2014 IRF PPS final rule (78 FR 47860), as well as the revisions to the list of diagnosis codes that are used to determine presumptive compliance under the "60 percent rule" finalized in this rule, will be effective for compliance review periods beginning on or after October 1, 2015. This final rule will also address the implementation of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), for the IRF prospective payment system (PPS), effective when ICD-10-CM becomes the required medical data code set for use on Medicare claims and IRF-PAI submissions.

 
Agency: Department of Health and Human Services(HHS)  Priority: Economically Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Completed Actions 
Major: Yes  Unfunded Mandates: No 
CFR Citation: 42 CFR 412   
Legal Authority: Social Security Act, sec 1886(j)    PL 106-554    PL 106-113   
Legal Deadline:
Action Source Description Date
Final  Statutory    08/01/2014 
Timetable:
Action Date FR Cite
NPRM  05/07/2014  79 FR 26307   
NPRM Comment Period End  06/30/2014 
Final Action  08/06/2014  79 FR 45872   
Regulatory Flexibility Analysis Required: No  Government Levels Affected: None 
Small Entities Affected: Businesses  Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Gwendolyn Johnson
Health Insurance Specialist
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicare, MS: C5-06-27, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-6954
Email: gwendolyn.johnson@cms.hhs.gov

Kadie Thomas
Health Insurance Specialist
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Office of Clinical Standards and Quality, Mail Stop S3-02-01, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-0468
Email: kadie.thomas@cms.hhs.gov