CMS Releases the IRF and SNF Prospective Payment System Proposed Rules for FY 2022

Members & Publications

April 9, 2021

2022 IRF PPS Proposed Rule

On Wednesday, April 7, Centers for Medicare and Medicaid Services (CMS) released the 2022 IRF PPS Proposed Rule. This proposed rule would update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2022.

As required by statute, this proposed rule includes the classification and weighting factors for the IRF prospective payment system’s case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2022. This proposed rule also includes proposals for the IRF Quality Reporting Program (QRP).

Additionally, there is a request for information on ways to “close the health equity gap in PAC quality reporting programs,” specifically by supporting providers in Quality Improvement activities to reduce health inequities. Given the ongoing PHE and the transition in Administrations, there are not many new controversial policy proposals.

A fact sheet is here. AAPM&R is taking a closer look at the proposed rule text and will update membership accordingly. Comments are due to CMS on June 7.

2022 SNF PPS Proposed Rule

On Thursday, April 8, Centers for Medicare and Medicaid Services (CMS) released the SNF PPS Proposed Rule for FY 2022. This proposed rule would update the prospective payment rates for skilled nursing facilities (SNFs) for FY 2022. In addition, the proposed rule includes a proposed forecast error adjustment for FY 2022. The proposed rule also:

  • proposes updates to the diagnosis code mappings used under the Patient Driven Payment Model (PDPM)
  • proposes to rebase and revise the SNF market basket
  • proposes to implement a recently-enacted SNF consolidated billing exclusion along with the required proportional reduction in the SNF PPS base rates
  • includes a discussion of a methodology to recalibrate the PDPM parity adjustment.

Additionally, the proposed rule includes proposals for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Purchasing (VBP) Program. Similar to the IRF PPS Proposed Rule, the SNF proposed rule also includes a request for information on ways to “close the health equity gap in PAC quality reporting programs,” specifically by supporting providers in Quality Improvement activities to reduce health inequities.

A fact sheet is here. AAPM&R is taking a closer look at the proposed rule text and will update membership accordingly. Comments are due to CMS on June 7.

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.