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IRF Claim Processing

King & Spalding

CMS Issues Three Payment Rules for FY 2023

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On July 27, 2022, CMS issued final rules for FY 2023 in its yearly update to Medicare payment policies and rates under the Inpatient Rehabilitation Facilities (IRFs) prospective payment system (PPS) and the Inpatient...more

Baker Donelson

D.C. District Ct Applies Prohibition on Administrative and Judicial Review to IRF PPS Rates

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On July 25, 2016, Judge John D. Bates of the United States District Court for the District of Columbia issued a memorandum opinion broadly construing 42 U.S.C. ยง 1395ww(j) to prohibit administrative or judicial review of a...more

King & Spalding

OIG Releases Mid-Year Update to its Work Plan

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On May 28, 2015, the OIG published a revised version of its Work Plan for Fiscal Year (FY) 2015. As previously reported, the original version of the FY 2015 Work Plan was published in October and summarized the OIG's ongoing...more

King & Spalding

Federal District Court Vacates Decision of Medicare Appeals Council on Inpatient Rehabilitation Coverage

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In its recent decision in Teche Specialty Hospital v. Sebelius, the District Court for the Western District of Louisiana vacated two inpatient rehabilitation (IRF) coverage denials by the Medicare Appeals Council (MAC). The...more

Baker Donelson

Overview of the FY 2015 IRF Final Rule

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On August 6th, the Centers for Medicare and Medicaid (CMS) published an Inpatient Rehabilitation Facility (IRF) final rule [PDF] in the Federal Register outlining (1) new Medicare payment policies and rates; and (2) guidance...more

Bond Schoeneck & King PLLC

Health Care: CMS Issue Inpatient Rehabilitation Final Payment Rule For 2015 (8/14)

On July 31, 2014, the Centers for Medicare & Medicaid Services (CMS) issued a final rule, published in the Federal Register on August 6, 2014, updating fiscal year (FY) 2015 Medicare payment policies and rates for the...more

Baker Donelson

Highlights of Proposed Rules for Skilled Nursing Facilities, Inpatient Rehabilitation Facilities, and Inpatient Psychiatric...

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On May 1, 2014, CMS released proposed payment and policy changes for Medicare Skilled Nursing Facilities (SNFs), Inpatient Rehabilitation Facilities (IRFs), and Inpatient Psychiatric Facilities (IPFs). Some of the key changes...more

King & Spalding

CMS Proposes Two-Percent Net Payment Update for IRFs in FY 2014

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On May 2, 2013, CMS released its proposed FY 2014 inpatient rehabilitation facility (IRF) PPS rule, which includes a 1.8 percent net market basket update and a 0.2 percent increase for high-cost outlier payments. ...more

Baker Donelson

CMS Clarifies IRF Claim Processing

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CMS published revisions to the inpatient rehabilitation facility (IRF) section of the Medicare Claims Processing Manual (Chapter 3, Section 140 of Pub. 100-04) in Transmittal 2638 on January 18, 2013. According to CMS, the...more

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