This week in Medicare updates—8/4/2021
States’ Backlogs of Standard Surveys of Nursing Homes Grew Substantially During the COVID-19 Pandemic
On July 27, the OIG published a Report regarding the backlog on standard surveys of nursing homes during the COVID-19 pandemic. This report was published as an addendum following a December 2020 report, which found that states conducted surveys at 31% of nursing homes from March 23 through May 30, 2020, a much lower number than surveys conducted during the same time period during the previous year. This new report showed that 71% of nursing homes nationwide went at least 16 months without a standard survey as of May 31, 2021. States are required to conduct standard surveys of Medicare/Medicaid-certified nursing homes at least every 15 months. While these surveys were temporarily suspended at the beginning of the pandemic, CMS authorized states to resume standard surveys in August 2020 as soon as states had the resources to do so. The OIG said this continuing backlog underscores the importance and urgency of its previous recommendation to CMS to clarify expectations for states to complete backlogs of these surveys and recommends CMS issue guidance on prioritization of surveys and issue required timeframes in which to complete these backlogs. CMS said it will continue to work with states on addressing this issue.
FY 2022 Inpatient Psychiatric Facility (IPF) Prospective Payment System (PPS) Final Rule
On July 29, CMS published a draft copy of the FY 2022 IPF PPS Final Rule, which will be published in the Federal Register on August 4. CMS finalized an IPF payment rate update of 2.0%, but additional updates to the outlier threshold increase the total IPF payment to 2.1% for FY 2022. CMS finalized changes to the IPF PPS teaching policy for displaced residents due to IPF hospital closures and closures of IPF teaching programs. This aligns the IPF teaching policy with the IPPS policy as finalized in the 2021 IPPS final rule. The rule also finalized a handful of changes to the IPF Quality Reporting Program, including a measure regarding COVID-19 vaccines for healthcare personnel.
CMS published a Fact Sheet on the final rule on the same date. The rule is effective October 1, 2021.
FY 2022 Skilled Nursing Facility (SNF) PPS Final Rule
On July 29, CMS published a draft copy of the FY 2022 SNF PPS Final Rule, which will be published in the Federal Register on August 4. CMS finalized an aggregate payment increase of 1.2%, which does not incorporate the SNF value-based purchasing (VBP) reductions estimated to be at $184.25 million in FY 2022. CMS also finalized a reduction in the Part A SNF rates to account for the exclusion of specific blood clotting factors for patients with hemophilia and other bleeding disorders as required by the Consolidated Appropriations Act of 2021. In response to stakeholder feedback, CMS also changed many of the PDPM ICD-10 code mappings affecting sickle-cell disease, esophageal conditions, multisystem inflammatory syndrome, neonatal cerebral infarction, vaping-related disorder, and anoxic brain damage. The rule also included a technical correction to the physical environment requirements that LTC facilities must meet to participate in Medicare/Medicaid. It additionally updates to the SNF Quality Reporting Program and the SNF Value-Based Purchasing Program, including a policy suppressing the use of the SNF readmission measure in scoring and payment adjustments due to the effect of the PHE on this measure.
CMS published a Fact Sheet on the final rule on the same date. The policies are effective October 1, 2021.
FY 2022 Inpatient Rehabilitation Facilities (IRF) PPS Final Rule
On July 29, CMS published a draft copy of the 2022 IRF PPS Final Rule, which will be published in the Federal Register on August 4. CMS is updating the total IRF PPS payments by 1.5% for FY 2022. CMS also finalized a variety of changes to the IRF Quality Reporting Program as well as finalizing an exclusion from DMEPOS fee schedule adjustments for wheelchair accessories and seat and back cushions. It also modified the regulatory definition of an “item” under the DMEPOS competitive bidding program at 42 CFR 414.402 to exclude certain types of wheelchairs and related accessories.
CMS published a Fact Sheet on the final rule on the same date. The regulations are effective October 1, 2021.
FY 2022 Hospice Payment Rate Update Final Rule
On July 29, CMS published a draft version of the FY 2022 Hospice Payment Rate Update Final Rule, which will be published in the Federal Register on August 4. Policies include a 2.0% increase in hospice payments for 2022 and an aggregate cap amount of $31,297.61. CMS also finalized a policy rebasing and revising labor shares using the 2018 Medicare cost reports for freestanding hospices. The rule finalized certain changes to hospice Conditions of Participation which had been waived during the COVID-19 PHE, including allowing the use of pseudo-patients for hospice aide competency training/testing and conducting competency evaluations related to deficiencies and related skills noted during a hospice aide supervisory visit. It also finalized clarifying text changes on certain aspects of the hospice election statement addendum requirements.
CMS published a Fact Sheet on the final rule on the same date. The regulations are effective October 1, 2021.
Comment Request: Medicare Beneficiary Experiences with Care Survey (MBECS) System; CLIA Collection of Information Requirements Related to SARS–CoV–2 Test Results Reporting
On July 29, CMS published a Comment Request in the Federal Register regarding the submission of the following information collections for OMB review:
- Medicare Beneficiary Experiences with Care Survey (MBECS) System
- CLIA Collection of Information Requirements Related to SARS–CoV–2 Test Results Reporting
Comments are due to the OMB desk officer by August 30.