The Centers for Medicare & Medicaid Services (CMS) has issued several proposed rules affecting the prospective payments systems for hospitals (IPPS), skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), inpatient psychiatric facilities (IPFs) and other Medicare providers. NASL will review CMS' proposals and provide additional details in the near future. 

The pre-publication copy of the Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2015 (FY15 SNF PPS) proposed rule went on display at the Office of the Federal Register's Public Inspection Desk on May 1, 2014. The proposed rule is expected to be published in the Federal Register on May 6, 2014. The proposed rule provides a 2.4% annual market basket update, which is reduced by 0.4 percentage point multifactor productivity adjustment. CMS projects the net increase to SNFs will be $750 million or 2.0% increase over payments in FY2014. Included in the proposed rule is reporting on CMS' Part A Therapy Research Project. Proposed changes identified during an initial review include CMS' proposed revision for policies related to the Change of Therapy (COT) Other Medicare Required Assessment (OMRA). The proposed rule also discusses "observed trends related to therapy utilization among SNF providers" and "accelerating health information exchange in SNFs." CMS also restates its commitment to "accelerating health information exchange (HIE) through the use of electronic health records (EHRs)" and cites the ONC proposed rule on voluntary certification criteria. Read NASL's response to the ONC's proposed rule. Read the pre-publication copy of the FY15 SNF PPS proposed rule. NASL will provide a more detailed review in the near future. 

The pre-publication copy of the Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2015 (FY15 IRF PPS) proposed rule went on display at the Office of the Federal Register's Public Inspection Desk on May 1, 2014. The proposed rule is expected to be published in the Federal Register on May 7, 2014. Highlights from a quick review of the document include: CMS' proposal to collect data on therapy provision by discipline, to revise codes related to the 60 % Rule compliance criteria, to add a new item to the IRF-PAI assessment instrument and to update quality measures and reporting requirements. Read the pre-publication copy of the FY15 IRF PPS proposed rule. 

This week, CMS posted reports based on its Developing Outpatient Therapy Payment Alternatives (DOTPA) project available electronically. The DOTPA Measurement Report, which can be requested via email, looks at the performance of assessment items as measures of patient functional impairment. The DOTPA Payment Alternatives Report considers payment alternatives for Medicare outpatient therapy services. The DOTPA Final Report describes overall results, lessons learned from the DOTPA project and future research. CMS also posted the DOTPA CARE-C and CARE-F Assessment Forms used to collect items of information on the DOTPA patient sample on CMS.gov.