Inpatient rehabilitation facilities and long term care hospitals that do not submit to Medicare data on specific quality measures soon will see their Medicare payments reduced by 2 percent under payment policy changes becoming effective within months.

Starting this year, the Centers for Medicare and Medicaid Services will send letters to Medicare contractors listing providers who have not met quality data reporting requirements, and these providers will be subject to reduced reimbursement.

The penalty starts on August 11, 2015 for inpatient rehabilitation facilities who for fiscal 2014 have not submitted quality data. Measures that must be reported cover pressure ulcers, catheter-associated urinary tract infection, influenza vaccinations for staff and residents, 30-days readmission rate, and staph and clostridium difficile infection.

However, not all measures must be reported this year, they are phased in over three years. Only catheter-associated urinary tract infection and new or worsened short-stay pressure ulcers are to be reported this year for FY 2014 quality measures. Influenza vaccination for residents and staff are added in fiscal 2016 for fiscal 2015 reporting, and all measures must be reported in FY 2017 for FY 2016 measures. More information is available here.

Also See: Providers Unprepared for Revenue Cycle Changes

The scenario is similar for long term care hospitals that have until Sept. 2, 2015 before penalties hit, and with the quality measures to report also being phased in over three years. FY 2014 quality measures that must be reported this year include catheter-associated urinary tract infection, central line-associated bloodstream infection, and new or worsened short-stay pressure ulcers.

Additional measures added in FY 2016 reporting of FY 2015 measures include residential and staff influenza vaccinations. Three more new measures come in FY 2017 for reporting from FY 2016: facility-wide inpatient hospital-onset staph, facility-wide inpatient hospital-onset clostridium difficile infection and 30-day all-cause unplanned readmission. More information is available here.

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