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RTN1305_B7_CMS-1599-P


CMS: Proposal to revise the Medicare hospital inpatient prospective payment systems (IPPS) and change the Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program [Pearl: CMS, F&B, GB, JCSC, LDR, MDx, PI, RNx] CMS-1599-P: April 26, 2013, 3 Pgs

Heads up! The inexorable push to connect payment to performance is advancing again. About this time last year CMS was proposing the Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program as a part of CMS-1588-P. The new rule proposed using six psychiatric care performance measures (HBIPS 1-6), all of which had been available as trial measures under the The Joint Commission’s ORYX program since October 20081, and were then being promoted to be required measures for Medicare reimbursement.  You need to know that the Affordable Care Act (ACA) requires the implementation of a quality reporting program for the inpatient psychiatric facilities (IPF), and units that are reimbursed under Medicare’s IPS FFS for fiscal year 2014 and subsequent years. In addition, IPFs must report quality data according to CMS’ requirements or incur a two percent reduction for non-compliance (effective FY 2014 based on performance measured over a six-month period spanning Q4 of CY 2012 through Q1 of 2013).  This current proposed ruling (1599-P) will tweak the Hospital Inpatient Prospective Payment Systems and redefine the benchmark used to determine medical necessity for an inpatient claim (from 24 to 48 hrs). It also proposes to add three new measures for the FY 2016 payment determination and subsequent years for the IPFQR Program. CMS-1599-P is scheduled to be finalized on August 1, 2013.  The proposed new measures are:
(1) Alcohol Use Screeningassesses the number of patients 18 years of age and older who were screened for alcohol use using a validated screening questionnaire for unhealthy drinking during their inpatient stay.
(2)  Alcohol & Drug Use: Assessing Status After Dischargeassesses whether discharged patients are contacted between 7 and 30 days after hospital discharge in order to collect post discharge follow-up information regarding their alcohol or drug use status.
(3) Follow-Up After Hospitalization for Mental Illness – assesses the percentage of discharges for patients 6 years of age and older who were hospitalized for treatment of selected mental health disorders, and who subsequently had an outpatient visit or an intensive outpatient encounter with a mental health practitioner, or received partial hospitalization services.
Tip: Leadership (Especially CEO, CFO, Med/Nursing/PI Directors) should review/discuss the proposed new measures and consider providing feedback to CMS2 before the June 25, 2013 deadline.  Why? … because it is likely these measures will soon effect your funding and reporting workload.

See also:

• Details for Title: CMS-1599-P
• Details for: Proposed Policy And Payment Changes For Inpatient Stays In Acute-Care Hospitals And Long-Term Care Hospitals
•Details for: CMS Proposals To Improve Quality Of Care During Hospital Inpatient Stays

1Note: When the IPFQR with its 6 measures was first proposed (CMS-1588-P, May 11, 2012), it was estimated that 450 (@ 26%) of approximately 1700 existing IPFs were already reporting the proposed measures to The Joint Commission.
2Note: You may submit electronic comments on this regulation at http://www.regulations.gov. Follow the instructions for ‘‘Comment or Submission’’ and enter the file code CMS–1599–P to submit comments on this proposed rule.  Alternately, you may post feedback in the comments section of this article and we will collect, aggregate and forward to CMS on your behalf.

 

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