This evening Center for Medicare & Medicaid Services (CMS) released the FY 2020 Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) and Quality Reporting Updates proposed rule.  CMS proposes to update the IPF PPS market basket by 1.85 percent for FY 2020 and to rebase the IPF market basket to 2016 base year- stating that the Agency would use more recent estimate of market basket in the final rule if more recent data becomes available. The proposed updates are to increase payments to IPFs in urban and rural areas by 1.71 percent and 1.63 percent, respectively.

CMS is also proposing to increase the per diem base rate, the payment inpatient psychiatric hospitals receive per-day to cover the costs of services for patient care, from $782.78 to $803.48. The per diem base rate is adjusted for patient diagnoses, patient comorbidities, and geography, among other factors. The proposed per diem base rate for hospitals that do not meet the quality data reporting requirements is $787.70. Additionally, CMS is looking to align the timeframes of the IPF wage index data and the inpatient prospective payment system (IPPS) hospital wage data by eliminating the 1-year lag of the pre-floor, pre-classified hospital wage index from which IPF wage index is currently based. If finalized, the new payment rates will apply to discharges between October 1, 2019 and September 30, 2020. These updates are expected to result in overall increase in program payments of $75 million in FY 2020.

The proposed rule includes the addition of a new measure on medication continuation following discharge to the IPF Quality Reporting (IPFQR) Program. CMS had previously proposed this measure in the FY 2018 IPPS & Long-Term Care Hospital (LTCH) PPS but it was never finalized. The new measure would use Medicare fee-for-service claims to track whether admitted patients with diagnoses of major depressive disorder, schizophrenia, or bipolar disorder fill at least one medication to use after being discharged. If finalized, discharges in the performance period July 1, 2017 and June 30, 2019 would be used for the FY 2021 payment determination.  The addition of this measure would result in 14 total measures in the IPFQR.

Comments are due June 17, 2019.