New Medicare Payment Rules for 2019 Finalized

Reprinted from an alert from the Centers for Medicare and Medicaid Services sent to CMS National Faith and Community Coalition Members:

Today, the Centers for Medicare and Medicaid Services finalized three 2019 Medicare payment rules for the Skilled Nursing Facility PPS, Inpatient Rehabilitation Facility PPS, and Inpatient Psychiatric Facility PPS. Individually and collectively, the final rules issued today put patients over paperwork, ease provider burden, and make significant strides in modernizing Medicare.

The Skilled Nursing Facilities (SNF) PPS final rule incorporates the agency’s Patients Over Paperwork initiative through avenues that reduce unnecessary burden on providers by easing documentation requirements and offering more flexibility. As part of the agency’s actions to modernize Medicare, the SNF PPS rule establishes an innovative new classification system, the Patient Driven Payment Model (PDPM), which ties skilled nursing facility payments to patients’ conditions and care needs rather than volume of services provided. The move to this model is expected to also save providers an estimated $2 billion over the next decade.

Of note in these rules is the continued work on the agency’s Meaningful Measures initiative. The goal of this initiative is a prudent measure set that focuses on the most critical quality issues and patient safety with the least burden for clinicians and providers. The Inpatient Rehabilitation Facility (IRF) PPS and Inpatient Psychiatric Facility (IPF) PPS final rules finalize policies that ensure the measures those providers must report are patient-centered and outcome-driven rather than process-oriented. Where applicable, these changes will allow providers to work with a smaller set of more meaningful healthcare measures and spend more time on patient care.

Today’s IRF PPS final rule reduces both administrative and documentation burden for IRF providers by well over 300,000 hours. By reducing regulatory documentation burden on IRF physicians, provisions in this final rule will allow more time to be spent on direct patient care.  Additionally, this final rule adopts advances in telecommunications technology by removing obstacles that may prevent rehabilitation physicians from conducting interdisciplinary team meetings without being physically in the room.

SNF:

For a fact sheet on the FY 2019 SNF PPS final rule please visit:
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2018-Fact-sheets-items/2018-07-31-3.html

IRF:

For a fact sheet on the FY 2019 Inpatient Rehabilitation Facility PPS final rule please visit:
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2018-Fact-sheets-items/2018-07-31.html

Psych:

For a fact sheet on the FY 2019 Inpatient Psychiatric Facility (IPF) PPS final rule please visit:
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2018-Fact-sheets-items/2018-07-31-2.html

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