CMS has issued a proposed rule to update rates for Medicare services furnished by inpatient psychiatric facilities (IPFs) during FY 2019. CMS estimates that the proposed rule would increase payments by $50 million (0.98%) compared to FY 2018 levels. This projected increase is a result of a 2.8% market basket update, reduced by both a 0.80 percentage point productivity adjustment and and a statutorily-mandated 0.75 percentage point reduction, which is further reduced by 0.27 percentage points due to an outlier fixed-dollar loss threshold adjustment. CMS proposes to update the IPF prospective payment system (PPS) federal per diem base rate from $771.35 to $782.01; the base rate would be $766.56 for providers who fail to report required quality data. Among other things, CMS provides an update on the status of IPF PPS refinements and solicits comments about differences in the IPF labor mix, patient mix, and provision of drugs and laboratory services to inform these refinements.

As in the acute inpatient PPS proposed rule, CMS includes a Request for Information to obtain feedback on policies to promote interoperability and electronic healthcare information exchange, including through possible revisions to hospital conditions of participation. CMS will accept comments on the proposed rule until June 26, 2018.

This article is presented for informational purposes only and is not intended to constitute legal advice.