HIDA Government Affairs Alert


August 13, 2014


HIDA Summarizes FY 2015 Hospital IPPS, IRF and SNF Final Rules


The HIDA Government Affairs team has reviewed the FY 2015 Hospital Inpatient (IPPS), Inpatient Rehabilitation Facility (IRF) and Skilled Nursing Facility (SNF) Prospective Payment System final rules and summarized the important policy takeaways.


In the IPPS summary, HIDA explains that the Centers for Medicare & Medicaid Services (CMS) expects hospital inpatient facilities will receive a 1.4% increase in Medicare reimbursement in FY 2015. Other key highlights from the final rule include:

  • 1.3% decrease in Medicare DSH payments
  • 3% maximum penalty finalized for higher than expected readmissions for FY 2015
  • 1 new readmissions measure for FY 2017
  • 3 new measures added for FY 2017 VBP
  • 1 new measure added for FY 2019 VBP
  • 6 clinical measures “topped out” from VBP
  • Reminds hospitals to make public a list of standard charges per the ACA
  • No changes to “two-midnight rule”

In the IRF summary, HIDA explains that CMS expects IRFs to receive an overall 2.4% increase in reimbursement payment rates for FY 2015. Other key highlights from the final rule includes:

  • Freeze facility level adjustment factors at last year’s level
  • Delays 60% Rule Presumptive Test until FY 2016
  • Removes 10 amputation related ICD-9 codes and 4 amputation and arthritis relative impairment group codes (IGC) from the presumptive compliance criteria in FY 2016
  • Adds therapy data collection and Arthritis Diagnosis Codes to the IRF-patient assessment instrument (IRF-PAI)for FY 2016
  • Adds two new measures to the quality reporting program

In the SNF summary, HIDA explains that CMS expects SNFs to receive an overall 2.0% increase in reimbursement payment rates for FY 2015. Other key highlights from the final rule includes:

  • Revises the SNF PPS wage index update
  • Implements a revision to the Change of Therapy (COT) Other Medicare Required Assessment (OMRA)
  • Revises the Civil Money Penalties regulations for SNFs

Please contact HIDA Government Affairs if you have any questions, hidagovaffairs@hida.org or (703) 549-4432.