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Tag Archives: Policy

[Announcement] Hospice Benefit: Final FY 2017 Payment and Policy Change

Hospice

Originally Published in MLN Connects

On July 29, CMS issued a final rule (CMS-1652-F) outlining FY 2017 Medicare payment rates and wage index and the Hospice Quality Reporting Program (QRP) for hospices serving Medicare beneficiaries. As finalized, hospices would see a 2.1 percent ($ 350 million) increase in their payments for FY 2017 (reflecting an estimated 2.7 percent inpatient hospital market basket update, reduced by a 0.3 percentage point productivity adjustment and a 0.3 percentage point adjustment required by law).

Changes to the Hospice QRP:

• Provides a description of the Hospice CAHPS® Survey and outlines participation requirements for the FY 2019 and FY 2020 annual payment updates
• Finalizes two new quality measures for FY 2017
• CMS expects to begin public reporting hospice quality measures via a Compare site in CY 2017

Enhanced Data Collection:

• CMS is considering enhancing the current Hospice Item Set (HIS) data collection instrument to be more in line with other post-acute care settings
• This revised data collection instrument would be a comprehensive patient assessment instrument, rather than the current chart abstraction tool

For More Information:

• Final Rule will become effective on October 1, 2016
• Hospice Center website

 

See the full text of this excerpted CMS fact sheet (issued July 29).

The Medical Management Institute – MMI – Medical Coding News & MMI Updates

[Announcement] SNFs: Final FY 2017 Payment and Policy Changes

On July 29, CMS issued a final rule (CMS-1645-F) outlining FY 2017 Medicare payment policies and rates for the Skilled Nursing Facility (SNF) Prospective Payment System (PPS), the SNF Quality Reporting Program (QRP), and the SNF Value-Based Purchasing (VBP) Program. CMS projects that aggregate payments to SNFs will increase in FY 2017 by $ 920 million, or 2.4 percent, from payments in FY 2016. This estimated increase is attributable to a 2.7 percent market basket increase reduced by 0.3 percentage points, in accordance with the multifactor productivity adjustment required by law.

Changes to the SNF QRP:

• Adopts three measures to meet the resource use and other measure domains and one measure to satisfy the domain of medication reconciliation
• SNFs that fail to submit the required quality data to CMS will be subject to a 2 percentage point reduction to the annual market basket percentage update factor for fiscal years beginning with FY 2018
• Policies and procedures associated with public reporting are being finalized, including the reporting timelines, preview period, review and correction of assessment-based and claims-based quality measure data, and the provision of confidential feedback reports to SNFs

SNF VBP Program:

• Specifies the SNF 30-Day Potentially Preventable Readmission Measure, (SNFPPR), as the all-cause, all-condition risk-adjusted potentially preventable hospital readmission measure as required by law

• Finalized additional policies, including establishing performance standards, establishing baseline and performance periods, adopting a performance scoring methodology, and providing confidential feedback reports to SNFs

For More Information:

• Final Rule will become effective on October 1, 2016
• SNF PPS website
• SNF QRP webpage
• SNF VBP webpage

 

See the full text of this excerpted CMS fact sheet (issued July 29).

The Medical Management Institute – MMI – Medical Coding News & MMI Updates

[Announcement] IRFs: Final FY 2017 Payment and Policy Change

On July 29, CMS issued a final rule (CMS-1647-F) outlining FY 2017 Medicare payment policies and rates for the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program (QRP). CMS is updating the IRF PPS payments for FY 2017 to reflect an estimated 1.65 percent increase factor (reflecting an IRF-specific market basket estimate of 2.7 percent, reduced by a 0.3 percentage point multi-factor productivity adjustment and a 0.75 percentage point reduction required by law). An additional approximate 0.3 percent increase to aggregate payments due to updating the outlier threshold results in an overall estimated update of approximately 1.9 percent (or $ 145 million), relative to payments in FY 2016.

• No changes to the facility-level adjustment
• Rural adjustment transition: Continue year two of the phase-out of the 14.9 percent rural adjustment for IRF providers in areas that were designated as rural and changed to urban under the new Office of Management and Budget delineations

    Changes to the IRF QRP:

    • Adopts three measures to meet the resource use and other measure domains and one measure to satisfy the domain of medication reconciliation
    • IRFs that fail to submit the required quality data to CMS will be subject to a 2 percentage point reduction to their applicable FY annual increase factor
    • Begin publically reporting IRF quality data in fall 2016
    • Adopted an extension of the time frame for submission of exception and extension requests for extraordinary circumstances from 30 days to 90 days from the date of the qualifying event

      For More Information:

      • Final Rule will become effective on October 1, 2016
      • IRF PPS website
      • IRF QRP website

        See the full text of this excerpted CMS fact sheet (issued July 29).

        The Medical Management Institute – MMI – Medical Coding News & MMI Updates

        [Announcement] Hospital IPPS and LTCH PPS Final Rule Policy and Payment Changes for FY 2017

        Hospital Discharges

        Originally Published in MLN Connects

        On August 2, CMS issued a final rule to update FY 2017 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS). The final rule, which would apply to approximately 3,330 acute care hospitals and approximately 430 LTCHs, would affect discharges occurring on or after October 1, 2016.

        The final increase in operating payment rates for general acute care hospitals paid under the IPPS that successfully participate in the Hospital Inpatient Quality Reporting (IQR) Program and are meaningful Electronic Health Record (EHR) users is approximately 0.95 percent. This reflects the projected hospital market basket update of 2.7 percent adjusted by -0.3 percentage point for multi-factor productivity and an additional adjustment of -0.75 percentage point in accordance with the Affordable Care Act. This also reflects a 1.5 percentage point reduction for documentation and coding required by the American Taxpayer Relief Act of 2012 and an increase of approximately 0.8 percentage points to remove the adjustment to offset the estimated costs of the Two Midnight policy and address its effects in FYs 2014, 2015, and 2016.

        • In sum, CMS projects that total Medicare spending on inpatient hospital services, including capital, will increase by about $ 746 million in FY 2017
        • This projected increase in spending includes an estimated $ 350,000 increase in FY 2017 payments to hospitals located in Puerto Rico under the final policy to make IPPS payments for capital-related costs based solely on the national capital Federal rate

        The final rule also includes:

        • IPPS rate adjustments for documentation and coding and Two-Midnight Policy Medicare uncompensated care payments
        • CMS-1632-F & IFC: Finalization of the extension of the Medicare-Dependent Hospital Program and low-volume hospital adjustment provided by MACRA
        • Notification procedures for outpatients receiving observation services
        • Hospital-Acquired Condition Reduction Program
        • Hospital Readmissions Reduction Program
        • Medicare and Medicaid EHR Incentive Programs 
        • Hospital IQR Program
        • Hospital Value-Based Purchasing Program
        • PPS-Exempt Cancer Hospital Quality Reporting Program
        • Inpatient Psychiatric Facility Quality Reporting Quality Reporting Program
        • LTCH PPS changes
        • LTCH Quality Reporting Program


        See the full text of this excerpted CMS fact sheet (issued August 2).

        The Medical Management Institute – MMI – Medical Coding News & MMI Updates