Inpatient rehabilitation facilities would get a 1.7% rate increase from Medicare in fiscal 2016 under a proposed rule the CMS issued Thursday.
The policy would deliver $130 million more to rehabilitation facilities (PDF) than they received in fiscal 2015. However, the increase is significantly smaller than the 2.4% raise they received in fiscal 2015.
The rule would also make a portion of reimbursement contingent on facilities reporting on several new quality measures. The measures—which Medicare is also applying to long-term care, skilled nursing and home health providers—would track the percentage of patients with new or worsened pressure ulcers; the percentage of patients with functional status assessments and care plans; and the percentage of patients experiencing falls causing major injuries.
Providers that fail to submit the data are subject to a two percentage-point reduction to their annual rate increase.
The CMS intends to publicly report quality data for rehabilitation facilities beginning in fall 2016. Before the data's release, facilities will have an opportunity to review and correct information.
The CMS also announced plans to suspend a previously finalized data-validation policy. The policy required randomly selected providers to meet a 75% data accuracy threshold for information submitted to the agency or risk a reduction in payments.
The agency said it was suspending the policy “in order to allow time to develop a more comprehensive policy that potentially decreases the burden on IRF providers, allows us to establish an estimation of accuracy related to quality data submitted to CMS.”
There are more than 1,100 inpatient rehabilitation facilities in the U.S. that treat nearly 400,000 Medicare beneficiaries each year.
