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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. |
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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:
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Timetable:
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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 |