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Medical Rehab

This article from Capitolwire is a good and extensive overview of what is going on with the budget here in Harrisburg. Health and Human service budget line items are still fluid until the House and Senate negotiate a final budget deal. RCPA will provide updates on any budget deal, and RCPA encourages members to continue to contact the governor and state legislators to inform them why it’s necessary for them to pass a state budget sooner rather than later. Questions, contact Jack Phillips.

The College for Behavioral Health Leadership will be hosting a symposium to focus on population health for behavioral and physical health on Wednesday, January 20, 2016, in Washington, DC. During this one day event, the focus will be on the components of population health, and how behavioral and physical health can work together to impact the triple aim of improving care for individuals, reducing costs, and improving health. Please consider joining us on January 20 to learn more and become part of the solution.

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On Thursday, December 10, 2015, from 12:30–1:30 pm, the Centers for Medicare and Medicaid Services (CMS) will conduct a special open door forum to provide a summary of the dry run for inpatient rehabilitation facilities (IRFs) on all-cause unplanned readmissions for 30-day post discharge from IRFs. To participate in the call, dial: 800-837-1935; conference ID: 93892614. Prior to the call, the presentation slides will be posted to the IRF Quality Reporting Spotlight & Announcements page on the CMS website.

On November 23, the leadership of the Office of Mental Health and Substance Abuse Services (OMHSAS), including Deputy Secretary Dennis Marion and Medical Director Dr. Dale Adair, provided a webcast presentation on the development of Applied Behavior Analysis (ABA) services for children with an Autism Spectrum Disorder (ASD). The webcast to more than 130 RCPA members reviewed the current concepts and recommendations developed by a clinical work group, assisting OMHSAS in the development of ABA medical necessity guidelines, clarifying the authorization pathway for Behavioral Health Rehabilitation Services for children and adolescents diagnosed with Autism Spectrum Disorder.

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The Centers for Medicare and Medicaid Services released a Request for Information (RFI) in the November 20, 2015 Federal Register. The RFI is geared to Inpatient Rehabilitation Facilities (IRFs) and will assist in the design and development of a survey regarding patient and family member experiences with the care received in the IRF. Comments will be received until 5:00 pm on Tuesday, January 19, 2016.

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As a reminder to members, inpatient rehabilitation facility (IRF) quality reporting program (QRP) data collected between April 1, 2015 and June 30, 2015 must be submitted by Sunday, November 15, 2015. Additional information, including a list of the quality measure data that is due, is available on the IRF Quality Reporting Spotlight and Announcements web page.

Home Care Rule
Linda Drummond, RCPA director, Intellectual and Developmental Disabilities Division, is working with the PA State Independent Living Council and Temple’s Institute on Disabilities, to determine the impact of the new US Department of Labor’s Home Care Rule on providers. Please share any questions, issues, or recommendations regarding this rule with Linda Drummond, for inclusion with the document being developed for the Department of Human Services, on areas of concern impacting service providers on implementation of this rule. This may be impacting LifeSharing/Shared Living, Participant Directed, and Companionship services.

Today, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule, Revisions to Requirements for Discharge Planning for Hospitals, Critical Access Hospitals, and Home Health Agencies. This revises the discharge planning requirements for hospitals (including inpatient rehabilitation facilities and long term care hospitals), critical access hospitals, and home health agencies; these requirements must be met in order to participate in the Medicare and Medicaid programs. The proposed rule also implements the discharge planning requirements of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, which strives to improve consumer transparency and beneficiary experience during the discharge planning process, by developing a discharge plan based on the goals, preferences, and needs of each patient.

 

Under the proposed rule, hospitals would be required to develop a discharge plan within 24 hours of admission or registration and complete a discharge plan before the patient is discharged home or transferred to another facility. These requirements will apply to all inpatients, and certain types of outpatients, including patients receiving observation services, patients undergoing surgery (or other same-day procedures where anesthesia or moderate sedation is used), and emergency department patients who have been identified as needing a discharge plan. In addition, hospitals will be required to:

  • Provide discharge instructions to patients who are discharged home;
  • Have a medication reconciliation process with the goal of improving patient safety by enhancing medication management;
  • For patients who are transferred to another facility, send specific medical information to the receiving facility; and
  • Establish a post-discharge follow-up process.

The proposed rule is scheduled to be published in the November 3, 2015 Federal Register with a 60-day comment period.

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The Centers for Medicare and Medicaid Services recently identified a system’s error when calculating payments for inpatient rehabilitation facility (IRF) providers. To correct this error, a special wage index under the fiscal year 2016 IRF prospective payment system (PPS) will need to be implemented. This system fix will be implemented sometime around October 26, 2015. Providers’ Medicare administrative contractor will mass adjust affected IRF PPS claims with dates of service on or after October 1, 2015. No provider action is required.

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In the October 1, 2015 Federal Register, the Centers for Medicare and Medicaid Services (CMS) released a Request for Information (RFI) to seek public comment related to new provisions in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This is for the design of the new Medicare physician payment system that will replace the Sustainable Growth Rate (SGR) formula, which includes the merit-based incentive payment system, alternative payment models, and a physician-focused payment model. Originally, comments were due by November 2, 2015; however, an extension of the comment period for an additional 15 days was published in the October 20, 2015 Federal Register, indicating the new due date as Tuesday, November 17, 2015.