Proposed rules offer insight into the Administration’s priorities.
The Centers for Medicare & Medicaid Services (CMS) has issued its first proposed payment rules under the Biden Administration. While these rules are required to update Medicare payment rates for different provider types, they also give us insights into the new Administration’s priorities.
On Wednesday, April 7, CMS announced proposed rules for the FY 2022 Payment and Quality Reporting Updates for Inpatient Psychiatric Facilities (IPFs), and for the FY 2022 Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS). In doing so, CMS said it is seeking feedback on ways to attain health equity for all patients through policy solutions. This is consistent with Executive Order 13985, on Advancing Racial Equity and Support for Underserved Communities. CMS is working to make healthcare quality more transparent to consumers and providers, enabling them to make better choices, as well as promoting provider accountability as it pertains to health equity.
CMS’s ongoing commitment to closing the health equity gap in IRFs has been demonstrated by the adoption of standardized patient assessment data elements (SPADEs), which include several social determinants of health (SDoH) that were finalized in the FY 2020 IRF PPS final rule for the IRF Quality Reporting Program (QRP) (84 FR 39149 through 39161). CMS is seeking comment on the possibility of expanding measure development and the collection of other SPADEs that address gaps in health equity in the IRF QRP.
In the Inpatient Psychiatric Facility Proposed Rule, CMS is requesting comment on future potential stratification of quality measure results by dual eligibility and other social risk factors in facility-specific reports, marking ways to improve demographic data collection, and the potential creation of a facility equity score to synthesize results across multiple measures and social risk factors.
Regarding the annual payment updates, total estimated payments to IPFs are estimated to increase by 2.3 percent, or $90 million, in FY 2022, relative to IPF payments in FY 2021. For FY 2022, CMS is proposing to update the IPF PPS payment rates by 2.1 percent. There are also a number of proposed changes to the IPF quality reporting system, including the following:
Regarding IRFs, For FY 2022, CMS is proposing to update the IRF PPS payment rates by 2.2 percent. And for the IRF QRP:
Comments on the proposed rules and requests for information are due by June 7.
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