July 29, 2019
IRFs Begin Final Countdown for Big Changes Ahead
We have been reminding inpatient rehabilitation facilities (IRFs), repeatedly of late, and now we’re down to the final two months before the transition away from utilizing Functional Independence Measures (FIMtm) to assign patients to a case-mix group (CMG) and toward using key quality indictor data – specifically, the GG Self-Care…
June 20, 2019
IRF Count Down Continues: Part II
There’s an updated version of the IRF-PAI manual. As we prepare for changes in how inpatient rehabilitation facilities (IRFs) are paid through the utilization of quality indicator data rather than Functional Independence Measure (FIMTM) scores to classify patients into appropriate case-mix groups (CMGs), it’s important that IRFs provide the most…
December 21, 2018
News Alert: CMS: Clarifies Counting of Student Therapy Minutes
IRFs can breathe easier; no change in policy. CMS has clarified the question of counting minutes of therapy provided by students. The Inpatient Rehabilitation Facility (IRF) world reacted in shock to an unexpected statement made during a November Medicare Learning Network call wherein a Centers for Medicare & Medicaid Services…
November 19, 2018
News Alert: CMS May Disallow Counting of Student Therapy Minutes
A brewing problem, or simply an area for clarification for IRFs? During what was expected to be a plain vanilla review of the Inpatient Rehabilitation Facility Prospective Payment Systems (IRF-PPS) Coverage Requirements and Updates from the FY 2019 Final Rule, the Centers for Medicare & Medicaid Services (CMS) made…
September 20, 2018
Medicare and Medicaid Regulations Suspended During Natural Disasters
CMS provides Medicare waivers for providers dealing with natural disasters. I live in North Carolina, and as most of you have seen on the news, we just underwent a natural disaster. Its name is Hurricane Florence. Our Governor has declared a state of emergency, and this declaration is extremely important…
September 18, 2018
News Alert: Medicare Approves Recovery Audit Program for IRFs
RAC issue for IRFs has moved from being proposed to being approved. The Centers for Medicare & Medicaid Services (CMS) recently posted a potential Complex Medical Review for (inpatient rehabilitation facilities) IRFs. The issue: 0A024-Inpatient Rehabilitation Facility (IRF) Stays: Meeting Requirements in the proposed Recovery Audit Contractors (RAC) Topics list…
September 6, 2018
RACs Poised to Audit IRFs: Reasonable, Necessary Care
If approved, reviews would impact RAC Regions 1 through 4 in all states.In November 2017, the Centers for Medicare & Medicaid Services (CMS) announced that proposed Recovery Auditor (RAC) review topics would be posted. These topics, which have been proposed, but not yet approved, are available on the Medicare Provider…
Experts warn of challenges for IRFs in FY 2020. The final rule for fiscal year (FY) 2019 for Inpatient Rehabilitation Facility (IRF) Payment has been published and there are a few changes between the proposed rule and the final one. What might be of even more interest to IRFs are…
June 28, 2018
IMPACT 2014: Where Are We Now?
Those in post-acute care should frequently check for any new reports on this subject. The Centers for Medicare & Medicaid Services (CMS) sponsored an FAQ call on June 21 concerning IMPACT (Improving Medicare Post-Acute Care Transformation), which is directed by the legislation of the same name enacted in 2014. This…
CMS guidance about medical review changes for inpatient rehabilitation facilities (IRF): Bonus or baggage? There has been lots of buzz about Medicare’s most recent clarifications to contracted auditors related to auditing therapy minutes for inpatient rehabilitation facilities (IRFs). The news first surfaced on Dec. 11 in MLN Matters SE17036, which…
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Allen Jost, PhDAlvin Gore, MD, CHCQM and Cathi Charlberg, LVN, CHCQMAmanda Gilliland, RN, BSNAndrew B. Wachler, Esq.Andrew H. Hughes, MD and Charles Locke, MD, CHCQM-PHYADVAndrew Wachler and Kaitlin NucciAndrew Wachler, Esq., and Sarah Hillegonds, Esq.Angela Phillips, PTBarbara Vandegrift, RN, BSN, MABecky Rodrian, CPC, CEMC, CBCS, MBSBrian T. LandryChristina Panos, RHIA, CTRChristopher Halleman, DOChristopher J. Laney, Esq.Chuck BuckDaniel Zirkman, MDDavid M. Glaser, Esq.Denise Nash, MD, CCS, CIMDheeraj Mahajan, MD, FACPDuane Abbey, PhD, CFPEdward Roche, PhD, JDElizabeth C. Dunbar, MD, MBA, FACEP, CHCQM-PHYADVEllen Fink-Samnick MSW, ACSW, LCSW, CCM, CRPErica E. Remer, MD, FACEP, CCDSErin Diesel Roumayah, Esq.Frank D. Cohen, MPA, MBBGlenn Krauss, RHIA, BBA, CCS, CCS-P, CPUR, CCDS, C-CDI, PCS, FCS, C-CDAMGloryanne Bryant, RHIA, RHIT, CCS, CCDSGreg FordHolly Louie, RN, CHBMEJ. Paul Spencer, CPC, COCJanelle Ali-Dinar, PhDJeffrey D. Lehrman DPM, FASPS, MAPWCAJessica Forster, Esq.John K. Hall, MD, JD, MBA, FCLM, FRCPCJuliet B. Ugarte Hopkins, MD, CHCQM-PHYADVKathleen K. Borchard, BSN, RN-ACMKathy Seward, MD, CHCQM-PHYADVKim T. Charland, BA, RHIT, CCSKnicole C. Emanuel Esq.Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-approved ICD-10-CM/PCS trainerLaurie M. Johnson, MS, RHIA, FAHIMALori O’Hara, MA, CCC-SLPMark SpiveyMarvin D Mitchell, RN, BSN, MBAMary Beth Pace, RN, BSN, MBA, ACM, CMACMary Inman, Esq. and Max Voldman, Esq.Matthew AlbrightMax Voldman, Esq.Melinda Battaile, MD, FHM, MMCI, CHCQM-PHYADV, CCDSMichael A. Salvatore, MD, FACPMichael Rosen, Esq.
