CMS has issued its final rules for 2018 Medicare payment rates and policy updates for skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs) and hospices.  

There were slight decreases in aggregate payments for two of the rules compared to the proposed rules released in April. For SNFs, aggregate payments will increase by $370 million, or 1 percent, compared to fiscal year 2017, below the $390 million in the proposed rule. For IRFs, the jump will be $75 million, or 0.9 percent, a cut from the proposed rule’s $80 million increase. For hospices, payment remained steady between the proposed and final rules, increasing by $180 million, or 1 percent in 2018. 

Many of the other elements of the proposed rules were unchanged in the finalized regulations. For example, the SNF rule will update the current pressure ulcer quality measure and add four new measures in 2020 dealing with self-care and mobility for medical rehab patients beginning in the 2020 program year.

For IRFs, the rule finalizes the removal of the 25 percent payment penalty for missing deadlines to transmit patient assessment information. It decided against certain changes to the 60 percent rule, which requires 60 percent of admissions to IRFs to have one of 13 qualifying conditions. The proposed rule had suggested removing certain ICD-10-CM codes from the current methodology, but comments from facilities led CMS to not finalize the change.

“We will continue to monitor and consider their appropriateness for inclusion on the presumptive methodology lists for future policy development and rulemaking,” the agency said.