FY 2021 Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS)

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• FY 2021 Inpatient Psychiatric Facilities
  Prospective Payment System (IPF PPS)

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FY 2021 Inpatient Psychiatric Facilities
Prospective Payment System (IPF PPS)

• The CMS is finalizing a rule that further
  advances our efforts to support the Medicare
  program by better aligning payments for inpatient
  psychiatric facilities (IPFs) with the costs of
  providing care. The final rule will update
  Medicare payment policies and rates for the IPF
  Prospective Payment System (PPS) for FY 2021.
  These policies will help the CMSs priority of
  Strengthening Medicare and help guarantee that
  seniors can access the care they need at the site
  of care they choose.
• According to CMS, they are finalizing a 2.2
  percent payment rate update and finalizing its
  proposal to adopt revised Office of Management
  and Budget (OMB) statistical area delineations
  resulting in wage index values being more
  representative of the actual costs of labor in a
  given area.
• IPF Prospective Payment System
• CMS have to pay for inpatient psychiatric
  services on a per diem basis under IPF PPS,
  according to the Balanced Budget Refinement Act
  of 1999.
• IPFs include
• Medicare participating psychiatric hospitals
• certified psychiatric units in acute care
  hospitals or critical access hospitals.

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FY 2021 Inpatient Psychiatric Facilities
Prospective Payment System (IPF PPS)
CMS will use most recent available data to
update payments for FY 2021 IPF PPS final rule.
The IPF PPS applies to approximately 1500
inpatient psychiatric facilities. IPF PPS
Payment updates IPF Payments Update CMS has
estimated total IPF payments to increase by 2.3
percent or 95 million in FY 2021. IPF market
based increased by 2.2 percent, which is used to
update IPF payment rates. Total estimated
payments to IPFs are approximately to increase
0.1 percent point. This is happening due to
updates in outlier threshold amount to maintain
estimated outlier payments at 2 percent of total
estimated payments. Adoption of revised Office of
Management and Budget (OMB) Statistical
Area. CMS is adopting revised Office of
Management and Budget (OMB) delineations from OMB
Bulletin No. 18-04. This bulletin established
revised delineations for Metropolitan Statistical
Areas, Micropolitan Statistical Areas, and
Combined Statistical Areas, and provided guidance
on the use of the delineations of these
statistical areas, thereby, resulting in wage
index values being more representative of the
actual costs of labor in a given area.
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FY 2021 Inpatient Psychiatric Facilities
Prospective Payment System (IPF PPS)
CMS is finalizing its proposed policy that any
decline in a providers wage index value from its
FY 2020 wage index, regardless of the
circumstance causing the decline, will be capped
at a 5 percent decrease for FY 2021. Inpatient
Psychiatric Facilities Quality Reporting (IPFQR)
Program For FY 2021 CMS adopts policies for the
IPFQR Program that remain in effect for
subsequent years after adopting those
policies. Changes to Scope-of-Practice
Regulations under the IPF PPS CMS is finalizing
updates to the regulatory language to allow
advanced practice providers, including physician
assistants, nurse practitioners, psychologists,
and clinical nurse specialists, to operate within
the scope of practice allowed by state law by
documenting progress notes in the medical record
of patients, for whom they are responsible,
receiving services in psychiatric hospitals. The
current regulation is inconsistent with other
recent changes finalized throughout the hospital
conditions of participation and unnecessarily
imposes regulatory burden on psychiatric
hospitals. The FY 2021 IPF PPS final rule can be
downloaded from the Federal Register
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FY 2021 Inpatient Psychiatric Facilities
Prospective Payment System (IPF PPS)
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