American Speech-Language-Hearing Association
August 5, 2011

Medicare Increases 2012 Rates for Inpatient Rehabilitation Facilities

Medicare reimbursement rates for inpatient rehabilitation facilities (IRFs) stays will increase by 2.2%, effective October 1, 2011, according to final regulations released by the Centers for Medicare and Medicaid Services (CMS). This affects 200 freestanding rehabilitation hospitals and more than 1,000 rehabilitation units in acute-care hospitals. The final revisions complete a 10-year regulatory process that removes differences in the way payments are determined for freestanding IRFs and for IRF units in hospitals.

A quality reporting system, authorized by the Affordable Care Act, will be initiated in fiscal year (FY) 2012 (which begins Oct. 1, 2011), but this system will not directly affect speech-language or audiology services at this time. In the first year of the system, IRFs will be required to report urinary tract infections associated with catheters and new or worsening pressure ulcers. CMS will add other measures for reporting through future proposed rules.

The regulation also updates FY2012 relative weights for case-mix groups. Under the prospective payment system, patient stays are assigned to case-mix categories organized by clinical problems and expected resource use. Each category has relative weights. Information from each patient's admission and discharge assessment helps determine the patient's category and payment distinctions within the category (relative weights). A higher relative weight translates into a higher payment to the IRF for that patient's stay. CMS used FY2010 IRF claims and FY2009 cost report data to make the adjustments.

Although CMS had indicated the possibility of establishing restrictions on group treatment in IRFs, neither the proposed nor the final regulations addressed this issue.

For additional information, please contact Mark Kander, ASHA's director of health care regulatory analysis, by e-mail at mkander@asha.org.


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