Medicare program; inpatient rehabilitation facility prospective payment system for federal fiscal year 2014. Final...

Area of Science:

• Health Policy
• Healthcare Administration

Background:

• Federal fiscal year (FY) 2014 regulations mandate updates to inpatient rehabilitation facility (IRF) prospective payment rates.
• Statutory requirements necessitate adjustments to IRF payment structures and compliance methodologies.

Purpose of the Study:

• To update IRF prospective payment rates for FY 2014.
• To revise the "60 percent rule" compliance calculation for presumptive compliance.
• To enhance IRF facility-level adjustment factors and quality reporting programs.

Main Methods:

• Updating prospective payment rates based on statutory requirements.
• Revising diagnosis code lists for "60 percent rule" compliance.
• Employing an enhanced estimation methodology for facility-level adjustment factors.
• Updating the Inpatient Rehabilitation Facility-Patient Assessment Instrument and quality reporting requirements.

Main Results:

• Finalized prospective payment rates for inpatient rehabilitation facilities for FY 2014.
• Revised criteria for "presumptive compliance" under the "60 percent rule".
• Updated facility-level adjustment factors and quality reporting measures.

Conclusions:

• The final rule establishes updated payment rates and operational requirements for IRFs for FY 2014.
• Revisions aim to improve accuracy in compliance calculations and facility adjustments.
• Updated quality measures and reporting enhance the IRF quality reporting program.