CMS Issues Proposed Updates for FY 2018

May 4, 2017

The Centers for Medicare & Medicaid Services (CMS) issued several proposed annual Medicare payment rules for fiscal year (FY) 2018, including inpatient and long-term care hospitals (LTCHs) [PDF], skilled nursing facilities (SNFs) [PDF], and inpatient rehabilitation facilities (IRFs) [PDF]. Of particular interest, the proposals update annual payment rates, modify the quality reporting programs, and request information on ways that the Administration can make regulations more transparent and less burdensome for hospitals and clinicians. Several proposals have potential implications for ASHA members. Comments on the proposed rule and the associated Request for Information (RFI) can be submitted by any member of the public, and ASHA will be commenting by June 13, 2017. CMS has developed a fact sheet summarizing the provisions of the proposed rule.

CMS Request for Information

In addition to the payment and policy proposals, CMS released an RFI to generate ideas and better achieve transparency, flexibility, program simplification, and innovation. CMS expressed an interest in starting a national conversation about improving the health care delivery system, including (a) how Medicare can contribute to making the delivery system less bureaucratic and complex and (b) how Medicare can reduce the burden for clinicians, providers, and patients in a way that increases quality of care and decreases costs.

Payment Rate Changes

The Long-Term Care Hospital Prospective Payment System (LTCH PPS) rate would be reduced by approximately 3.75%, or $173 million, in FY 2018. The Inpatient Prospective Payment System (IPPS) rate would be increased by 1.6% for facilities successfully reporting quality and meaningful use measures in FY 2018. The SNF PPS and IRF PPS would each be increased by 1% in FY 2018.

Quality Reporting Program

Changes are proposed for FY 2020 related to quality measures that facilities are required to report to CMS. Specific measures vary according to settings, and more information will be provided when the final rules are released in the late fall.

Standardized Patient Assessment Data

CMS is also proposing that, beginning with the FY 2020 program year, LTCHs begin reporting standardized patient assessment data with respect to the following five specified patient assessment categories required by law:

  1. Functional status
  2. Cognitive function
  3. Special services, treatments, and interventions (including respiratory treatment associated with ventilators and tracheostomy care; nutrition associated with feeding tubes and enteral feeding; and hearing)
  4. Medical conditions and co-morbidities
  5. Impairments

ASHA Resource

Please contact Sarah Warren, ASHA's director of health care regulatory advocacy, at 301-296-5696 or, with any questions or for more detailed information.

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