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Authors Posts by Melissa Dehoff

Melissa Dehoff

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Melissa Dehoff is responsible for all medical rehabilitation and brain injury service issues. Ms. Dehoff attends multiple state-level meetings to advocate on behalf of members on brain injury and rehabilitation issues and is a member of the Department of Health Traumatic Brain Injury Advisory Board.

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The Centers for Medicare and Medicaid Services (CMS) has published the draft inpatient rehabilitation facility patient assessment instrument (IRF-PAI) version 4.4. This version of the IRF-PAI becomes effective on October 1, 2026.

This draft version has the following modifications from the current IRF-PAI Version 4.2:

  • IRF-PAI Item 8. Gender – has been moved to IRF-PAI Item A0810. Sex.
  • IRF-PAI Item 14. Admission Class – has been removed.
  • Transportation Item A1250 – has been modified into Transportation Item A1255 with new item verbiage and response options and is only to be collected at admission. Transportation item A1250 has been removed from the discharge assessment.
  • Item O0350. Patient’s COVID-19 vaccination is up to date – has been removed from the discharge assessment.

As finalized in the fiscal year (FY) 2026 Final Rule, draft version 4.4 also removes the Section R Social Needs items. The four items removed were social determinants of health (SDoH) data elements related to living situation, food, and utilities, which were previously scheduled to be implemented October 1, 2026.

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The final agenda for the Long-Term Services and Supports (LTSS) Subcommittee meeting on December 3, 2025, has been released. As a reminder, this meeting will be conducted via webinar and remote streaming only and will take place from 10:00 am – 1:00 pm. Register here to attend. The conference line for the meeting: 1 (415) 655-0052 PIN: 883-556-407#

Comments and questions may be sent electronically.

Remote streaming is available here.

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The Long-Term Services and Supports (LTSS) Subcommittee meeting was recently held on November 12, 2025. During the meeting, a number of presentations were provided. In addition to the presentations, the agenda and a document that provided follow-up items from the LTSS Subcommittee meeting on October 1, 2025, were provided.

Members should take time to review the PowerPoint presentations from the meeting below:

The next LTSS Subcommittee meeting is scheduled for Wednesday, December 3, 2025. The meeting will be held virtually only from 10:00 am – 1:00 pm. Register here to participate. Participants also have the option to call in by dialing (415) 655-0052; Access code: 883-556-407#.

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Harrisburg, USA - May 24, 2017: Pennsylvania capitol interior dome colorful ceiling in city with American Flags

On November 17, 2025, from 10:30 am – 3:00 pm, a Brain Injury Awareness Day will be held in Harrisburg at the State Capitol Rotunda. The day is dedicated to advocacy for survivors, caregivers, and professionals. Discussion topics will focus on the lack of a rate increase for brain injury residential providers and key brain injury legislation. The schedule for the day is below:

Main Rotunda

  • 10:00 am: Arrive at Main Rotunda
    • Visit vendor tables, take literature, conversations
  • 10:15 am: Group Picture
  • 10:30 – 11:30 am: Briefing

Legislative Offices

  • 11:40 am – 12:50 pm: Legislative Meetings
    • Attendees — Please schedule your own meetings.

Senate Room 8E-B

  • 1:00 pm – 2:00 pm: Reception
  • 2:00 pm – 3:00 pm: Survivors of brain injury share their experiences

Download the 2025 BI Awareness Day flyer for further details.

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Novitas Solutions has released the Cycle 2 results for the inpatient rehabilitation facility (IRF) review choice demonstration (RCD). The Cycle 2 results letters were issued on September 10, 2025, and are available in Novitasphere.

IRFs will have a 2-week choice selection period for Cycle 3 from October 7, 2025 – October 20, 2025, using the Novitasphere portal.

Cycle 3 Choice Selection Options

If the approval rate meets or exceeds target affirmation rate of 85% for Cycle 2 (based on a minimum of 10 submitted pre-claim review requests or claims), the IRF may select 1 of the 3 subsequent review choices:

  • Choice 1: Pre-claim review (PCR)
  • Choice 3: Selective post-payment review (default if no review choice is made)
  • Choice 4: Spot check prepayment review

If the IRF’s affirmation or claim approval rate is less than the target affirmation rate or they have not submitted at least 10 requests/claims, the IRF must again choose from 1 of the initial 2 options:

  • Choice 1: Pre-claim review (PCR)
  • Choice 2: Post-payment review (default if no review choice is made)

Cycle Stats Reminder

IRFs can access information about their affirmation/approval rate at any given time during the current or previous review cycle through the Cycle Stats option in Novitasphere. Visit here for more information on cycle stats.

IRF RCD Questions

Questions or concerns regarding the IRF RCD should be directed to the IRF Customer Service line at 855-340-5975, Monday – Friday, 8:00 am – 6:00 pm.

IRF RCD Resources and Educational Opportunities

Visit the Inpatient Rehabilitation Facility (IRF) Review Choice Demonstration (RCD) web page for important information about the IRF RCD and upcoming educational events, including a recording of the September 24, 2025, webinar on IRF RCD: Cycle 2 Results and Transitioning to Cycle 3.

Important Deadlines

  • October 7, 2025 – October 20, 2025, Cycle 3 Choice Selection
  • November 1, 2025 – April 30, 2026, Cycle 3 Review Dates
  • On or before May 30, 2026, Cycle 3 Affirmation/Approval Rate Communication

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On September 23, 2025, the Centers for Medicare and Medicaid Services (CMS) issued a policy clarification related to the qualifications for speech-language pathologists (SLP) when furnishing Part B outpatient therapy services.

These Part B services include speech-language pathology services that:

  1. Are furnished by SLPs in private practice (SLPPPs) who submit professional claims; and
  2. Are furnished and billed by providers of outpatient therapy services as defined at 42CFR489.2.

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The agenda for the October 1, 2025, virtual Long-Term Services and Supports (LTSS) Subcommittee meeting has been released. The meeting will be held from 10:00 am – 1:00 pm. Information specific to this meeting is below:

Comments and questions should be sent electronically.

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On September 24, 2025, WellSky will be conducting a webinar on the fiscal year (FY) 2026 inpatient rehabilitation facility prospective payment system (IRF PPS) final rule that was released by the Centers for Medicare and Medicaid Services (CMS) in early August. The webinar will begin at 12:00 pm. There is no cost to participate in this webinar.

Topics will include:

  • The key changes in the 2026 IRF Final Rule impacting reimbursement;
  • The technical changes and their indirect effects on your program;
  • The amendments to the QRP and the appeal process; and
  • The latest concerns about potential IRF reimbursement denials.

To participate in the webinar, register here.

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