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Medical Rehab

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The Centers for Medicare and Medicaid Services (CMS) has released the fiscal year (FY) 2025 inpatient rehabilitation facility prospective payment system (IRF PPS) proposed rule. The proposed rule will be published in the March 29, 2024, Federal Register. A high-level overview of the proposed rule is provided below:

Payment Updates:

CMS estimates an overall increase in aggregate payments to IRFs by 2.5% or $255 million (compared to the 4% payment update in FY 2024).

Market basket update for IRF services is 3.2%. This will be reduced by a productivity adjustment of 0.4%, which would result in an overall 2.8% increase. These figures are likely to change due to updated forecasts.

CMS is proposing to update the outlier threshold amount from $10,423 (FY 2024) to $12,158 (FY 2025), which would account for an estimated 0.2 percent decrease to aggregate payments across the IRF PPS in FY 2025.

Quality Reporting Program (QRP) Updates:

CMS is proposing to make additions, modifications, and removals of some QRP measures. A proposal was included to collect four new Standardized Patient Assessment Data Elements (SPADE) in the IRF QRP to bolster the collection of information on social determinants of health (SDOH):

  • Living Situation: Requests regarding the current living situation;
  • 2 Food Items: Questions about food running out;
  • Utilities: Questions about threats to shutting off utilities; and
  • A modification to an existing SPADE on Transportation.

CMS is also proposing to remove the “Admission Class” from the IRF Patient Assessment Instrument (PAI).

Feedback is requested on future revisions to the IRF QRP, as well as feedback on the development of a five-star methodology for IRFs.

Additional information will be forthcoming. Comments on the proposed rule are due to CMS by the end of May.

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The next phase of the Centers for Medicare and Medicaid Services (CMS) inpatient rehabilitation facility (IRF) review choice demonstration (RCD) is scheduled to be implemented in Pennsylvania on June 17, 2024, and will last for five years. This demonstration applies to only IRF providers physically located in Pennsylvania.

Between May 3, 2024, and June 2, 2024, IRFs must select either 100% pre-claim review or 100% post-payment claim review.

CMS has stated that creating a review choice process will ensure Medicare coverage and documentation requirements are likely met. This program reduces the number of Medicare appeals, improves provider compliance with Medicare program rules, does not alter the Medicare IRF benefit, and should not delay medically necessary care to Medicare beneficiaries.

Novitas Solutions is the Medicare Administrative Contractor (MAC) for Pennsylvania and will process the IRF claims. In preparation for the implementation of IRF RCD, Novitas Solutions will be conducting their first webinar on April 24, 2024, from 1:00 pm – 2:30 pm. Registration to participate in this webinar is now open. Members are strongly encouraged to participate in this webinar to prepare for this demonstration. If the registration link does not work, please copy and paste the below link into your browser to register:
https://fcso.webex.com/webappng/sites/fcso/meeting/register/0fd87e2111f7446fa477d0a25f78674c?ticket=4832534b000000073a942d9e6f94601b6b106adc8f502bcee359653432e8c326edb0f50ebc253329&timestamp=1711559626291&RGID=re6663754d2fe70defe3195e29c69465a

In addition to information on the CMS website, Novitas Solutions has a dedicated website that provides a great deal of information and resources on IRF RCD.

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RCPA hosted our 2024 Capitol Day today, March 19 inside the Main Rotunda. The rally focused on workforce issues within health and human services as well as budget items addressed in Shapiro’s 2024/25 budget. You can view our 2024 legislative and administrative priorities here.

RCPA President and CEO Richard Edley addressed the crowd, highlighting the continued need for funding, training, and assistance for those working in various areas of health and human services.

Other organizations came to support our cause as well as to advocate for themselves, their families, and their loved ones. Sherri Landis, Executive Director of The Arc of PA, spoke to the audience, while RCPA member Step by Step, Inc. showed up dressed in orange, ready to stand and offer their support!

Legislators also took to the stand to speak about the ongoing crises occurring in health and human services. Representative Stephen Kinsey and Representative Doyle Heffley, Co-Chairs for the House Human Services Committee, conveyed their support, as did Representative Dan Miller, Representative Frank Farry, and Senator Art Haywood, Co-Chair for the Senate Health & Human Services Committee.

RCPA thanks everyone, from legislators and their staff to advocates representing their friends and families, for coming out and supporting our efforts today. We appreciate and admire the work you do for our communities and will continue to serve on your behalf!

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Time is running out to register for RCPA’s Capitol Day, which will be held next Tuesday, March 19. Don’t miss out on this opportunity to advocate for yourselves and others by meeting with legislators directly! We will hold a press conference in the Main Rotunda between 10:30 am – 11:30 am, which will tentatively include speakers such as:

  • Representative Dan Miller;
  • Representative Stephen Kinsey;
  • Representative Doyle Heffley;
  • Senator Art Haywood; and
  • Senator Frank Farry.

You can register for our Capitol Day press conference by contacting Allison Brognia or Christine Tartaglione with the number of anticipated attendees. RCPA requests that members schedule appointments with their Senate and House legislators directly to discuss the state budget, legislation, and regulations after our press conference.

To help support our members and their families during these visits, RCPA asks that you use the following handouts:

Please note that copies of materials will also be available at the Capitol Rally. As an additional resource, members can visit the Pennsylvania Capitol website to locate parking and view maps of the building. If you have questions regarding our 2024 Capitol Day, please contact Jack Phillips.

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The Brain Injury Association of America (BIAA) will be conducting a virtual Brain Injury Fundamentals course on March 20, 2024 from 1:00 pm – 2:00 pm. The course will provide foundational knowledge about working with individuals who have a brain injury, and is ideal for non-licensed health care professionals, first responders, and support staff.

This course is self-paced, so those who are unable to participate in the in-person course due to scheduling conflicts or other commitments have the opportunity to complete the course with greater flexibility. Please note that while the self-paced option offers 24/7 access for independent learning and development, there is a two-hour live instructor component as well. To participate in the session, please register here.

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Image by photosforyou from Pixabay

Part 1: Navigating Evidence: Finding and Synthesizing Literature for Evidence-Based Practices
Tuesday, April 23, 2024
2:00 pm – 3:00 pm EDT; 1:00 pm – 2:00 pm CDT;
12:00 pm – 1:00 MDT; 11:00 am – 12:00 pm PDT
Register Here

Part 2: Making Evidence-Based Practices Work: Strategies and Outcomes
Tuesday, April 30, 2024
2:00 pm – 3:00 pm EDT; 1:00 pm – 2:00 pm CDT;
12:00 pm – 1:00 MDT; 11:00 am – 12:00 pm PDT
Register Here

Michael Peterson, MA, CCC-SLP
Speech-Language Pathologist and Clinical Transformation Specialist

Speaker Bio:
Michael works as a Clinical Transformation Specialist, where he focuses his efforts as part of a Clinical Transformation team to promote a culture of evidence-based practice at Gillette Children’s Specialty Healthcare in St. Paul, Minnesota. Michael is also a speech-language pathologist with 12 years of clinical experience working with children and adults with childhood-onset conditions. He applies his clinical experience and advanced training in knowledge translation and implementation science to partner with and guide clinical staff to bridge the gap between evidence and clinical practice.

Objectives: At the end of these sessions, the learner will:

Part 1: Navigating Evidence: Finding and Synthesizing Literature for Evidence-Based Practices

  • Describe how to search for literature using PICOT questions
  • Identify resources to support appraisal of relevant papers
  • State the purpose of synthesis tables in supporting evidence-based practice decisions
  • Describe how to use synthesis tables to make evidence-based practice recommendations

Part 2: Making Evidence-Based Practices Work: Strategies and Outcomes

  • Describe how frameworks guide implementation of EBP
  • State how barriers and facilitators influence implementation of EBP
  • Describe implementation strategies
  • List different kinds of outcomes to monitor implementation of EBP

Audience: This webinar is intended for all interested members of the rehabilitation team.

Level: Intermediate

Certificate of Attendance: Certificates of attendance are available for all attendees. No CEs are provided for this course.

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Join RCPA as we host the 2024 Annual Conference Embracing Challenges, Empowering Success from September 24 – 27 at the Hershey Lodge. The event is a highlight for the Pennsylvania behavioral health, brain injury, children’s, intellectual and developmental disabilities, medical rehabilitation, and physical disabilities and aging provider communities. RCPA staff and the Conference Committee are excited to release this year’s Sponsors, Exhibitors, and Advertiser Brochure, which features new opportunities to get in on the action and network with providers. Booth self-selection will also be available for exhibitors and exhibiting sponsors. In order to be considered for self-selection, a completed contract with payment must be submitted.

Network and Compete in Connections Hall
Connections Hall activities take place during the two busiest days of the conference, and many networking opportunities are available throughout the event. You’ll also be able to compete and have a chance to win “Best of Show!”

Sponsorship Opportunities Available
RCPA is privileged to have the backing of the finest organizations in the field for our conference. Through the use of sponsorship circles, RCPA is able to honor all supporting organizations.

Sign Up Now!
Sponsors, exhibitors, and advertisers who wish to be listed on the website, the mobile app, and in the conference program must submit all materials by August 23. Space and opportunities are reserved on a first-come, first-served basis, and no reservation is considered complete without payment. If questions remain, please contact Carol Ferenz, Conference Coordinator. The association looks forward to welcoming you at the conference!

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