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Insights and Trends

Insights and Trends

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Posts tagged “Regulatory News”

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Our Response: CMS Review Choice Demo and It’s Impact

Earlier this year, the Centers for Medicare and Medicaid Services (CMS) raised the possibility of moving forward with a proposed pre- or post-claim review demonstration program in up to four states in 2021 despite industry pushback. Since the initial announcement, CMS continues to push for advancement of the program. Stakeholders...

CMS’ 2022: How Will it Impact Behavioral Health?

The Centers for Medicare and Medicaid Services (CMS) recently released the Inpatient Rehabilitation Facility (IRF PPS), for fiscal year (FY) 2022. The payment rule took effect October 1, 2021.

CMS Likely to Move Forward with Review Choice Demo: What Could It Mean For Your Rehab Program?

Recently, the Centers for Medicare and Medicaid Services (CMS) raised the possibility of moving forward with a proposed pre- or post-claim review demonstration program in up to four states in 2021 despite industry pushback. Stakeholders noted the implementation of this program would increase the administrative burden already placed on providers...

Part B Reimbursement Changes: What You Need to Know

In late 2019, the Centers for Medicare and Medicaid Services finalized the Physician Fee Schedule for this calendar year, which includes several updates and changes to the provision, payment and paperwork related to Medicare Part B Physical Therapy services. These changes included new rules that have already gone into effect...

Preparing for the Transition from FIM to QI

We began working with our internal teams and partners in 2014 to prepare for the changes mandated through the IMPACT Act that would ultimately go into effect in 2019. In order to effectively transition from the long-used FIM tool to section GG, the IRF industry required a revised strategy with...

How Does Florida’s Repeal of Certain Hospital Certificate of Need Requirements Impact Rehab Hospitals?

Certificate of Need (CON) is a public policy tool which seeks to slow healthcare cost growth, avoid duplication of programs and services and ensure that new development meets the needs of the community. Nationally, only 12 states have no CON requirements. In Florida, the CON program was enacted in 1973...

IRF Final Rule Raises Important Concerns

On July 31, 2018, the IRF Final Rule was issued by the Centers for Medicare and Medicaid Services, which will take effect FY 2020. In addition to the updates to IRF payment rates and other measures designed to streamline care and reduce inefficiencies, one of the most important takeaways from...

Understanding the New Long Term Care Facilities “Megarule” Conditions of Participation Regulation and Phase 1

The Centers for Medicare and Medicaid Services finalized a major new rule approximately one month ago to make significant changes to improve patient care and safety. The new rule’s compliance obligations, which will be implemented in three phases that begin this year and extend through 2019, represent the largest update...