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Medical Rehab

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The Centers for Medicare and Medicaid Services recently identified a system’s error when calculating payments for inpatient rehabilitation facility (IRF) providers. To correct this error, a special wage index under the fiscal year 2016 IRF prospective payment system (PPS) will need to be implemented. This system fix will be implemented sometime around October 26, 2015. Providers’ Medicare administrative contractor will mass adjust affected IRF PPS claims with dates of service on or after October 1, 2015. No provider action is required.

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In the October 1, 2015 Federal Register, the Centers for Medicare and Medicaid Services (CMS) released a Request for Information (RFI) to seek public comment related to new provisions in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This is for the design of the new Medicare physician payment system that will replace the Sustainable Growth Rate (SGR) formula, which includes the merit-based incentive payment system, alternative payment models, and a physician-focused payment model. Originally, comments were due by November 2, 2015; however, an extension of the comment period for an additional 15 days was published in the October 20, 2015 Federal Register, indicating the new due date as Tuesday, November 17, 2015.

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The Centers for Medicare and Medicaid Services (CMS) has announced that a special open door forum for inpatient rehabilitation facilities (IRFs) will be held on Tuesday, October 20, 2015, from 2:00 to 3:00 pm. During the call, CMS will discuss the upcoming Dry Run for IRFs Provider Performance reports on All-Cause Unplanned Readmissions for 30-day post discharge from IRFs. This will also include timeline and content of facility dry run reports that will be disseminated to IRFs from November 3 through December 3, 2015.

To participate in this special open door forum call:
Dial: 1-866-402-6263
Conference ID #: 55982595

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The Departments of Human Services and Aging have extended an invitation for Managed Care Organizations (MCOs) and Home and Community-based Service (HCBS) providers to convene to discuss Community HealthChoices (CHC). The purpose of the meeting is to begin the conversation between the MCOs and providers, as the transition from fee-for-service to managed care begins.

The meeting has been scheduled for Wednesday, November 4, 2015, from 1:00 to 3:00 pm at the Radisson Hotel located at 1150 Camp Hill Bypass, Camp Hill, PA 17011.

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On Thursday, October 1, 2015, at 10:00 am, the House Energy and Commerce Health Subcommittee will hold a hearing, “Examining Potential Ways to Improve the Medicare Program,” that will include the review of three bills that strive to strengthen Medicare. The bills that will be examined include:

  • HR 1934, the Cancer Care Payment Reform Act, which would build on the promise of new provider delivery model development envisioned in the sustainable growth rate replacement policy, enacted into law earlier this year. This bill would establish a national oncology medical home demonstration project to improve Medicare payments for cancer care.
  • Draft legislation that would make changes to documentation and face-to-face requirements for home health providers under the Medicare program.

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One of RCPA’s members has asked for member feedback, via a survey on chronic pain patients that are being seen for Functional Capacity Evaluations (FCEs), to evaluate their eligibility to receive disability payments.

There are examples of where patients may not be physically able to return to their previous job, but would be able to perform other areas of work (more sedentary, less repetition, or other adaptations). However, many times these individuals continue to pursue disability because they do not know of, or have access to, other options.

We are curious if other members are providing FCEs for individuals applying for disability and if there are any return-to-work programs for individuals with chronic pain. Please complete this survey by Thursday, October 15, 2015, to have your responses included. Thank you for your participation.

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The Centers for Medicare and Medicaid Services (CMS) recently issued a revised inpatient rehabilitation facility patient assessment instrument (IRF PAI) training manual. The updated sections of the training manual are located on the IRF PAI web page under Downloads.

The revised training manual only covers the changes made to the IRF PAI, including:

  • Revisions to the language in the Table of Contents, Section 7: Comorbid Conditions and Section 11: Clarification of Terminology;
  • Section 2: Item-by-Item Coding Instructions;
  • Section 3: The Functional Independence Measure (FIM) – Revised Language;
  • Section 4: Quality Indicators – Revised Language; and
  • Section 6: ICD-10-CM Codes Related to Specific Impairment Groups – Updated to Reflect ICD-10 Codes.

The updated training manual becomes effective on Thursday, October 1, 2015.

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A national provider call focusing on the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 has been scheduled by the Centers for Medicare and Medicaid Services (CMS). The call has been scheduled for Wednesday, October 21, 2015, from 1:00 – 3:00 pm. Agenda topics include:

  • Legislative requirements of the IMPACT Act related to the use of standardized data, quality measures, resource use, and other measures for Skilled Nursing Facilities, Inpatient Rehabilitation Facilities, Long-Term Care Hospitals, and Home Health Agencies
  • Participation in the quality measure assessment and development process
  • Opportunities for stakeholder engagement and input

To participate in this call, providers must register. Space may be limited so early registration is recommended.

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On September 10, 2015, the Medicare Payment Advisory Commission (MedPAC) conducted a public meeting to discuss Medicare issues and policy questions and approve reports and recommendations to the Congress. Included in the agenda was a session that focused on MedPAC’s task of developing a prototype prospective payment system (PPS) that spans across the post-acute care (PAC) settings, as mandated by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. The IMPACT Act requires MedPAC to submit a report to Congress regarding this by Thursday, June 30, 2016. Included in the meeting was their presentation Mandated Report: Developing a Unified Payment System for Post-Acute Care. It is expected that MedPAC will conduct multiple public meetings in the months ahead regarding the development of PAC PPS before presenting their draft recommendations.

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The Centers for Medicare and Medicaid Services (CMS) published a correction notice in the August 25, 2015 Federal Register. This notice corrects technical and typographical errors that appeared in the Comprehensive Care for Joint Replacement Payment Model proposed rule that was published on July 14, 2015. The comment due date for the provisions contained in the proposed rule will remain at September 8, 2015.

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