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Washington Debrief: IPPS Final Rule Includes Reporting Period Changes, eCQM Submission in 2016

August 10, 2015
by Leslie Kriegstein, Interim Vice President of Public Policy, CHIME
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IPPS Final Rule Includes Reporting Period Changes, eCQM Submission in 2016

Key Takeaway: The Centers for Medicare & Medicaid Services last Friday issued its hospital Inpatient Prospective Payment System (IPPS) final rule for fiscal year 2016, which will increase rates by 0.9 percent after accounting for inflation and other adjustments required by law.

Why It Matters: Among the provisions included in the final payment rule, was a change to the time frame for the 2016 reporting year, so hospitals' participation would track the calendar year, rather than the fiscal year.

Overall, the rule will increase FY 2016 Medicare operating payments to acute-care hospitals by 0.9%, a slight decline from last year's 1.4% raise and from the 1.1% increase proposed in April. The rule includes a:

  • 2.4% market-basket update for facilities that were meaningful users of electronic health records in FY 2014 and submitted data on quality metrics;
  • 0.5% productivity cut;
  • 0.2% market-based cut, as required by the Affordable Care Act; and
  • 0.8% cut to meet the requirements of the American Taxpayer Relief Act of 2012

The final rule would require hospitals to submit four of 28 available eCQMs of their choice beginning in CY 2016 for the FY 2018 payment determination, down from 16 in the proposed rule. Additionally, hospitals will be required to submit one quarter (either Q3 or Q4) of electronic data in CY 2016 by February 28, 2017.

CMS also said in the final IPPS rule it will publish a request for information (RFI) on the establishment of an ongoing cycle for the introduction and certification of new clinical quality measures to be used in the meaningful use program. Clinical quality measure specifications have been published in the final rules for each stage of the Meaningful Use Program, but CMS hopes that an ongoing cycle of measures could help keep them updated, the agency said.

The final rule will be published in the Federal Register on August 17, 2015 and will be effective October 1, 2015.

DeSalvo’s Bid for Assistant Secretary of Health Moves Forward

Key Takeaway: When the Senate returns in September, Dr. Karen DeSalvo’s nomination will move to the Senate floor for consideration.

Why It Matters: Dr. Karen DeSalvo, the National Coordinator for Health IT, is one step closer to Senate confirmation as Assistant Secretary of Health at the Department of Health and Human Services (HHS) after the Senate Health, Education, Labor and Pensions (HELP) Committee last week gave unanimous consent to her nomination.

The Office of the National Coordinator for Health IT (ONC) and HHS have not announced a replacement for Dr. DeSalvo in her current role as National Coordinator.

There are 67 other Obama nominees pending votes, according to the Senate calendar.

Congressional Affairs:

Bill to Exempt ASCs from MU Penalties Heads to President’s Desk

Key Takeaway: Before leaving on its August recess, the Senate approved a bill to exempt patient encounters in ambulatory surgery centers (ASCs) from Meaningful Use requirements.

Why It Matters: The exemption set forth in the Electronic Health Fairness Act (S. 1347) states that physicians at ambulatory surgery centers (ASCs) be shielded from Meaningful Use penalties under the Medicare program.

The bill requires Centers for Medicare and Medicaid Services (CMS) to omit patient encounters in ASCs when determining whether a Medicare-participating physician is required to participate in the meaningful use program.

The bill also directs the Department of Health and Human Services (HHS) to develop special criteria for EHR systems for doctors who practice at ambulatory surgical centers. The bill’s exemption would be lifted after the criteria are created and an EHR designed for doctors in ASCs is certified by HHS for use in the Meaningful Use Program.

The Senate bill was sponsored by Senators Johnny Isakson (R-GA) and Michael Bennet (D-CO) while the House approved the bill, sponsored by Representative Diane Black (R-TN-6) and Representative David Scott (D-GA-13), on June 17, and it now heads to be signed into law by President Obama. 

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