From: CMS Transmittal 2393 (Pub 100-04) – 1/25/12
Summary of Changes
The purpose of this Change Request (CR) is to provide IRF hospitals updated instructions on submission of “no-pay” bills to Medicare for Medicare Advantage (MA) patients.
CMS E-mail Notice – 12/7/11
Text of CMS E-mail:
An update to the FY 2011 IRF pricer was posted by CMS on 12/3/11 and a correction to the FY 2012 (IRF) pricer was made by CMS on 12/6/11.
Inpatient Rehab PPS Final Rule Correction – FFY 2012
CMS-1349-CN; 9/26/11 FR
Corrections were issued by CMS on September 26, 2011 for the original final IP Rehab PPS rules that were released on August 5, 2011. These corrections are significant and required the re-issuance of the payments in Table 11. The September 26, 2011 corrected federal register includes the corrected payment rates effective October 1, 2011.
Inpatient PPS Final Rule Correction – FFY 2012
CMS-1518-CN3; 9/26/11 FR
Corrections were issued by CMS on September 26, 2011 associated with the August 18th 2011 final PPS rules for FFY 2012. The changes were mostly spelling errors. However there were some corrections that impacted the wage table information. CMS published an updated spreadsheet table containing tabs with a “CN” designation where changes were made impacting specific hospitals or CBSAs. Providers in Louisiana were primarily impacted by this correction. I have downloaded the updated wage index file for FY 2012. Click here to view the updated spreadsheet.
New Rehab Hospital – Late Filing for 100% Federal Reimb Election
PRRB-2011-D45 – September 15, 2011
This appeal involved a new Rehabilitation Hospital that requested to be reimbursed under the 100% Federal rate under the new prospective payment system. The provider received their Medicare enrollment letter on November 18, 2002 that was effective for services on or after September 24, 2002. On December 5, 2002 the provider sent a letter electing the fully federal prospective payment system. This request was rejected. The law requires this election to be made not later than 30 days before its first cost reporting period starts.
The PRRB rejected the provider’s request, given the specific requirements of the law.
IRF PPS Annual Update for FY 2012
MedLearn – 9/13/11
CMS Notice:
The FY 2011 Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) PC Pricer has been updated with corrected provider data. The PC Pricer is ready for download from the Centers for Medicare & Medicaid Services (CMS) web page at http://www.cms.gov/PCPricer/06_IRF.asp. If you use the IRF PPS PC Pricer, please go to the page above and download the latest version of the FY 2011 Pricers, updated 06/15/2011, in the Downloads section.