5/2/13 CMS issued a proposed rule called "Medicare Programs: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2014." The rule implements portions of the following sections of the ACA: 3004(b), 3401(d), 3401(p) and 10319.

The proposed rule outlines proposed fiscal year (FY) 2014 Medicare payment policies and rates for the inpatient rehabilitation facilities (IRFs) Prospective Payment System (PPS). The rule also updates and changes the IRF Quality Reporting Program (QRP). Updates include: revisions to the list of diagnosis codes used to determine presumptive compliance, updates to the IRF facility-level adjustment factors, revisions to sections of the Inpatient Rehabilitation Facility-Patient Assessment Instrument, revisions to the requirements for acute care hospitals that have IRF units and updates to the quality measures and reporting requirements under the IRF quality reporting program.

Comments are due July 1, 2013.

4/29/13 CMS issued a proposed rule called "Medicare Program; FY 2014 Hospice Wage Index and Payment Rate Update; Hospice Quality Reporting Requirements; and Updates on Payment Reform." The rule implements portions of the following sections of the ACA: 3003, 3008, 3025, 3132 (a), 3313, 3401(f), 10309 and 10322(a).

The proposed rule updates fiscal year (FY) 2014 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries. According to CMS, the proposed rule reflects ongoing agency efforts to support beneficiary access to hospice. Specifically, the rule updates the hospice payment rates and the wage index for fiscal year (FY) 2014, and continues the phase-out of the wage index budget neutrality adjustment factor (BNAF). The total BNAF reduction in FY 2014 will be 70%. The BNAF phase-out will continue with successive 15% reductions in FY 2015 and FY 2016. This proposed rule would also clarify how hospices are to report diagnoses on hospice claims, and proposes changes in the requirements for the hospice quality reporting program.

Comments are due June 28, 2013.

Read the CMS fact sheet about updates to the wage index and payment rates for the Medicare hospice benefit at: CMS.Gov

Read the proposed rule (which was published in the Federal Register on May 10, 2013) at: http://www.gpo.gov/fdsys/pkg/FR-2013-05-10/pdf/2013-10389.pdf

4/28/13 HHS/CMS issued a proposed rule called "Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Proposed Fiscal Year 2014 Rates; Quality Reporting Requirements for Specific Providers; Hospital Conditions of Participation." The rule implements portions of the following sections of the ACA: 3008, 3025, 3313, 3401(f), 10309, 10322(a).

The proposed rule updates Medicare payment policies and rates for inpatient stays to general acute care hospitals paid under the Inpatient Prospective Payment System (IPPS) and long-term care hospitals (LTCHs) paid under the LTCH Prospective Payment System (PPS) for FY2014. In addition to the annual Medicare hospital payment policy updates, the rule establishes new requirements or revised requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities (IPFs)) that are participating in Medicare. The rule also updates policies under the Hospital Value-Based Purchasing (VBP) Program and the Hospital Readmissions Reduction Program. The proposed changes would be applicable to discharges occurring on or after October 1, 2013, unless otherwise specified in the rule.

Comments are due July 25, 2013.

Read the CMS fact sheet about the changes for inpatient stays in acute-care hospitals and long-term care hospitals at: CMS.Gov

Read the CMS fact sheet about proposals to improve quality of care during hospital inpatient stays at: CMS.Gov 

For more information about PCORI funding opportunities, visit:

www.pcori.org/funding-opportunities.

For more information about PCORI, visit www.pcori.org