Medicare Raises Inpatient Rehabilitation Rates Medicare reimbursement rates for inpatient rehabilitation facilities (IRFs) will increase by 2.2%, effective Oct. 1, according to final regulations released by the Centers for Medicare and Medicaid Services (CMS). The changes to the prospective payment system will boost total IRF payments by approximately $150 million, and will affect 200 freestanding ... Bottom Line
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Bottom Line  |   September 01, 2011
Medicare Raises Inpatient Rehabilitation Rates
Author Notes
  • Mark Kander, director of health care regulatory analysis, can be reached at mkander@asha.org.
    Mark Kander, director of health care regulatory analysis, can be reached at mkander@asha.org.×
Article Information
Practice Management / Regulatory, Legislative & Advocacy / Bottom Line
Bottom Line   |   September 01, 2011
Medicare Raises Inpatient Rehabilitation Rates
The ASHA Leader, September 2011, Vol. 16, 8. doi:10.1044/leader.BML4.16112011.8
The ASHA Leader, September 2011, Vol. 16, 8. doi:10.1044/leader.BML4.16112011.8
Medicare reimbursement rates for inpatient rehabilitation facilities (IRFs) will increase by 2.2%, effective Oct. 1, according to final regulations released by the Centers for Medicare and Medicaid Services (CMS).
The changes to the prospective payment system will boost total IRF payments by approximately $150 million, and will affect 200 freestanding rehabilitation hospitals and more than 1,000 inpatient rehabilitation units in acute-care hospitals. The final revisions complete a 10-year regulatory process that removes differences in the way payments are determined for freestanding IRFs and for IRF units in hospitals.
Other Changes
A quality reporting system, authorized by the Affordable Care Act, will be initiated in fiscal year 2012 (which begins Oct. 1, 2011), but this system will not directly affect speech-language or audiology services at this time. In the first year of the system, IRFs will be required to report urinary tract infections associated with catheters and new or worsening pressure ulcers. CMS will add other measures for reporting through future proposed rules.
The regulation also updates FY 2012 relative weights for case-mix groups. Under the prospective payment system, patient stays are assigned to case-mix categories organized by clinical problems and expected resource use. Each category has relative weights. Information from each patient’s assessment, along with other information, determines the patient’s category and payment distinctions within the category (relative weights). A higher relative weight translates into a higher payment to the IRF for that patient’s stay. CMS used FY 2010 IRF claims and FY 2009 cost report data to make the adjustments.
Although CMS had indicated the possibility of establishing restrictions on group treatment in IRFs, neither the proposed nor the final regulations addressed this issue.
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September 2011
Volume 16, Issue 11