News & Insights


November 8, 2021

Health Headlines – November 8, 2021

King & Spalding Client Alert:  Biden Administration Unveils New COVID-19 Vaccination and Testing Requirements for Healthcare Workers – On November 4, 2021, CMS issued an interim final rule (IFR) that requires staff at 21 types of healthcare facilities and service providers that participate in Medicare or Medicaid programs to be fully vaccinated against COVID-19 by January 4, 2022. The IFR amends the respective Conditions of Participation, Conditions for Coverage, and Requirements for Participation in the Medicare and Medicaid programs for these facilities and providers to require these facilities and service providers to develop and implement policies and procedures to ensure all staff (with limited exceptions) are fully vaccinated. Further details about the IFR are included in the King & Spalding Client Alert found here

CMS Issues Outpatient Prospective Payment System Final Rule for CY 2022 – On November 2, 2021, CMS published the final rule to update the payment policies and rates for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment System for calendar year (CY) 2022. The highlights of the CY 2022 final rule include increasing the civil monetary penalties (CMPs) for noncompliance with the price transparency rules, halting the elimination of the inpatient only list, changing the list of covered procedures, and continuing the payment rate of Average Sales Price (ASP) minus 22.5 percent for 340B drugs. 

Payment Rate Updates

Hospitals should see increased reimbursements for services provided in accordance with the Outpatient Department (OPD) fee schedule. CMS is increasing the payment rates under the OPPS by an OPD fee schedule increase factor of 2.0 percent instead of the proposed 2.3 percent that includes a 2.7 percent market basket increase and a productivity adjustment of negative 0.7 percent. The previous conversion factor of $82.797 will be increased to $84.177 for CY 2022.  Due to COVID-19 Public Health Emergency (PHE)-related factors, CMS will be using the CY 2019 claims data to set the CY 2022 OPPS and ASC payment system rates instead of CY 2020.

Price Transparency Rules

The CY 2022 final rule increases the CMPs for hospitals that fail to comply with the Price Transparency Rule. CMS is applying a scaling factor to the CMPs for noncompliance. A hospital’s maximum daily penalty will be scaled based on the number of beds reported by the hospital in its most recently settled Medicare cost report. CMS adopted the proposed scale of $300 per day for a hospital with 30 beds or less (annual maximum of $109,500); $310-$5,500 per day ($10/bed/day) for 31-550 beds (annual maximum of $113,150 - $2,007,500); and $5,500 per day for a hospital with over 550 beds (annual maximum of $2,007,500).

CMS also made updates to the Price Transparency Rule requirement that hospitals post standard charges in a single machine-readable file on a publicly available website. CMS found that some hospitals had implemented barriers to accessing these files including implementing CAPTCHA in web applications and using methods that made it difficult to search for the files. In response, CMS added to the rule that the files must be accessible to automated searches and direct file downloads to remove these barriers to access.

Finally, CMS changed the rule so that forensic hospitals are deemed to have met the Price Transparency Rule’s requirements to decrease the burden on those state-funded hospitals providing services exclusively to individuals who are in custody and not the general public.

Payment for 340B-Acquired Drugs

In the CY 2022 proposed rule, CMS proposed to continue its policy of paying ASP minus 22.5 percent for 340B-acquired drugs and biologicals. CMS first introduced this policy in the CY 2018 final rule. Since that time, the policy has been the subject of ongoing litigation. That litigation is now pending before the Supreme Court, which is scheduled to hear oral argument on the case on November 30, 2021. 

Several commenters to the CY 2022 rule called on CMS to suspend its 340B-acquired drugs payment policy pending the outcome of the litigation. CMS declined to do so. Several hospitals also commented that they are paying more for 340B-acquired drugs than they are receiving from Medicare because ASP minus 22.5 percent does not represent the minimum discount that hospitals receive when they acquire drugs through the program. CMS disagreed, responding that 22.5 percent is actually a conservative estimate, and that its own survey indicated that the average discount was closer to 34.7 percent. CMS stated it “would not expect any 340B hospital to have acquisition costs for any acquired drug that are greater than ASP minus 22.5 percent.”

Other commenters suggested that CMS has not provided adequate evidence that its 340B payment policy remains budget neutral because the agency has not recalculated the impact since 2018 to account for changes in inflation or 340B drug utilization. CMS responded that it does not think it is necessary to revisit the budget neutrality estimate.

Notwithstanding the comments in opposition, CMS finalized without modification its proposal to continue paying ASP minus 22.5 percent for 340B-acquired drugs and biologicals.

Restoration of the Inpatient Only List

In the CY 2021 final rule, CMS eliminated the inpatient only (IPO) list over a period of three years. The agency started with removing 298 services from the IPO list in CY 2021.

In the CY 2022 proposed rule, CMS proposed to halt the elimination of the IPO list, and to restore the 298 services that were eliminated from the IPO list in CY 2021. CMS explained that it believes the IPO list safeguards patient safety. Instead of eliminating the IPO list wholesale, CMS proposed that any service removed from the list should be evaluated against the longstanding criteria for removal from the IPO list: whether outpatient departments are equipped to provide the service to the Medicare population, whether the simplest procedure described by the code can be furnished in most outpatient departments, whether the procedure is related to codes that have already been removed from the IPO list, whether the procedure is being furnished in numerous hospitals on an outpatient basis, and whether the procedure can be appropriately and safely furnished in an ASC.

Commenters generally supported CMS’s proposal to halt the elimination of the IPO list. In particular, commenters noted that when a procedure is removed from the IPO list, many payers, including Medicare Advantage plans, will consider outpatient status to be the assumed baseline site of service for the procedure, notwithstanding the patient characteristics or physician’s clinical assessment. Commenters also stated that eliminating the IPO list would create new operational challenges for both practitioners and facilities that would require additional time and resources to adjust to. In light of these comments, CMS restored the 298 services that were removed from the list in CY 2021. CMS also codified its five longstanding criteria for assessing whether a given service can safely be removed from the list. 

Changes to the ASC Covered Procedures List

In the CY 2021 final rule, CMS revised the safety criteria for including surgical procedures in the ASC Covered Procedures List (ASC CPL). The new criteria provided that the ASC CPL would include all procedures that are separately payable under the OPPS, are not on the IPO list, and can only be reported using an unlisted CPT code. The criteria that CMS used prior to CY 2021 for excluding procedures from the ASC CPL were repurposed to serve as safety factors for physicians to consider on a patient-by-patient basis. Based on the revised criteria, CMS added 267 procedures to the ASC CPL in CY 2021. 

In the CY 2022 proposed rule, CMS proposed to restore the safety criteria for determining procedures to be added to the ASC CPL that were in place prior to CY 2021. Under this proposal, the ASC CPL would include procedures separately paid under the OPPS that are not expected to pose a significant safety risk to a Medicare beneficiary when performed as an ASC and for which standard medical practice dictates that the beneficiary would not typically be expected to require active medical monitoring and care at midnight following the procedure. Furthermore, the general exclusion criteria would once again exclude procedures that (1) generally result in extensive blood loss, (2) require major or prolonged invasion of body cavities, (3) directly involve major blood vessels, (4) are generally emergent or life threatening in nature, (5) commonly require systemic thrombolytic therapy, (6) are designed as requiring inpatient care, and (7) can only be reported using a CPT unlisted surgical procedure code. CMS further proposed to remove 258 of the 267 procedures that were added to the ASC CLP in CY 2021 under the revised criteria.

CMS received mixed feedback for this proposal. While some commenters supported restoring the old criteria, others contended that the criteria adopted in CY 2021 more appropriately deferred to the clinical judgment of physicians, expanded beneficiary choice, and reduced costs. Notwithstanding these objections, CMS finalized without modification its proposal to restore the safety criteria for determining procedures to be added to the ASC CPL that were in effect prior to CY 2021. CMS also elected to remove 255 of the 258 procedures it had proposed to remove. The three codes that were not removed were 04997, 54650 and 60512.

Payment for Non-Opioid Drugs and Biologicals

Based upon comments received, CMS decided to revise its current non-opioid pain management policy to require that evidence-based non opioid alternatives for pain management must have Food and Drug Administration (FDA) approval either under a new drug application or an abbreviated new drug application, or if it is a biological product, be licensed under Public Health Service Act section 351. CMS also decided to implement its proposal that the drug or biologic must have a per-day cost in excess of the OPPS drug packaging threshold and have an FDA-approved indication for pain management or analgesia. Non-opioid pain management drugs that meet these criteria may be unpackaged and paid separately at ASP plus six percent when they are furnished in the ASC setting and function as surgical supplies. CMS noted that four supplies were eligible for separate payment under this policy.

Changes to Quality Reporting Measures

In the CY 2022 final rule, CMS adopted three new measures for the Hospital Outpatient Quality Reporting (OQR) Program. First, CMS will implement the COVID-19 vaccination coverage among healthcare personnel (HCP) measure that will require hospitals to report the percentage of HCP who have received a complete vaccination course against COVID-19. The measure will assess all HCP working in all inpatient or outpatient units that are physically attached to the hospital or the CCN. This measure will begin with the CY 2022 reporting period for the CY 2024 payment period. Although this would not be an outcome measure, CMS says that it will publicly report this data on a quarterly basis.

CMS also adopted a breast screening rate recall measure. This measure will calculate the percentage of Medicare beneficiaries for whom a diagnostic mammography, digital breast tomosynthesis (DBT), ultrasound of the breast, or magnetic resonance imaging of the breast is performed within 45 days of a traditional mammography or DBT. The measure will use data from the period July 1 through June 30 from 3 years before the applicable calendar year, beginning with CY 2023 payment determinations, which will use data from July 1, 2020 through June 30, 2021.

Third, CMS has adopted a measure to determine the percentage of emergency department (ED) patients with a diagnosis of STEMI who receive timely delivery of guidelines-based reperfusion therapies appropriate for the care setting. Specifically, the denominator will include all ED patients aged 18 or older who do not have contraindications to fibrinolytic, antithrombotic, and anticoagulation therapies. The numerator will include (1) ED-based STEMI patients whose time from ED arrival to fibrinolytic therapy is 30 minutes or fewer, (2) Non-transfer ED-based STEMI patients who received PCI at a PCI-capable hospital within 90 minutes of arrival, and (3) ED-based STEMI patients who were transferred to a PCI-capable hospital within 45 minutes of ED arrival at a non-PCI-capable hospital.  Reporting will be voluntary during the 2023 reporting period and become mandator in 2024 for CY 2026 payment determinations and subsequent years. 

Radiation Oncology Model

The Radiation Oncology (RO) Model is meant to test whether radiation therapy (RT) services payments made to physician groups and hospital outpatient departments that are not based on setting or type of care delivered over time increases the quality of care furnished to Medicare beneficiaries while also reducing incentives to provide less care. The RO Model was originally set to start on January 1, 2021. However, implementation was delayed until January 1, 2022 giving CMS time to propose additional modifications to the model. Now, the RO Model will begin on January 1, 2022 and end on December 31, 2026.

CMS’s modifications to the RO Model include, but are not limited to:

  • Moving the baseline period from 2016-2018 to 2017-2019;

  • Changing the discounts to 3.5 percent (professional component) and 4.5 percent (technical component);

  • Paying brachytherapy on a fee-for-service basis instead of including it in the RO Model;

  • Paying the traditional Medicare rate for beneficiaries who switch from traditional Medicare to Medicare Advantage before treatment is complete;

  • Permitting CMS to use an extreme and uncontrollable circumstances policy that gives CMS the ability to shift the model performance period and adjust the pricing model provided that CMS will notify participants on the RO Model website and in written correspondence;

  • Excluding hospital outpatient departments that are participating in the Pennsylvania Rural Health Model from participating in the RO Model;

  • Removing liver cancer from the RO Model because it does not meet the cancer inclusion criteria; and

  • Working on the definition of Track Three (one of three tracks) for the RO Model.

Rural Emergency Hospitals

Section 125 of the Consolidated Appropriations Act, 2021 established Rural Emergency Hospitals (REHs)—a new provider type that will be eligible to enroll in the Medicare program effective January 1, 2023. In the CY 2022 proposed rule, CMS solicited comments regarding the health and safety requirements that should apply to REHs, and conditions of participation that should apply to them. While CMS received numerous comments on this topic, it did not address them in the final rule. In the press release that accompanied the issuance of the final rule, CMS said that it “looks forward to taking each of those comments into consideration during the rulemaking process for the development of the REH requirements.” Since January 1, 2023 is the statutory implementation deadline for REHs, CMS is expected to implement them in the CY 2023 rulemaking. 

Temporary Policies for COVID-19

CMS sought comment on the extent to which stakeholders were using the flexibilities available under the COVID-19 waivers and whether those waivers should be made permanent. CMS specifically sought comment on furnishing services by hospital staff remotely through telehealth technology; remote supervision of certain services such as cardiac rehabilitation and pulmonary rehabilitation services; and the need for COVID-19 related specimen collection coding and payment under the OPPS. CMS stated that it will consider the comments received for future rulemaking.

The final rule is available here, and the CMS fact sheet is available here.

Reporters, Alek Pivec, Washington D.C., +1 202 626 2914, and Taylor Whitten, Sacramento, +1 916 321 4815,

CMS Releases Final Rule Regarding Payment Policies under the Physician Fee Schedule and Several Other Changes to Medicare Part B Payment Policies
Last week, CMS issued a final rule addressing several topics, including changes to the physician fee schedule (PFS) and changes to Medicare Part B payment policies. Key changes include a net reduction in the PFS conversion factor of $1.30, changes to policies for split (or shared) evaluation and management (E/M) visits, critical care services, and services furnished by teaching physicians involving residents, and revisions to the Medicare Shared Saving Program among other issues. The regulations go into effect on January 1, 2022.

2022 Rate-setting and Conversion Factor
CMS finalized a series of standard technical proposals involving practice expense, including standard rate-setting refinements, the implementation of the fourth year of the market-based supply and equipment pricing update, and changes to the practice expense for many services associated with the update to clinical labor pricing. After all adjustments, the calendar year (CY) 2022 PFS conversion factor is $33.59, a decrease of $1.30 from the CY 2021 PFS conversion factor of $34.89.

Changes to Billing Polices
CMS is making several changes to various billing policies.

  • Split or Shared E/M Services. CMS refined certain longstanding policies for split or shared E/M visits in an effort to reflect the current practice of medicine, the evolving role of non-physician practitioners (NPPs), and to clarify the Medicare conditions of payment for these services.  The CY 2022 PFS final rule establishes the following:

    • Split (or shared) E/M visits are defined as E/M visits provided in the facility setting by a physician and a NPP in the same group.

    • For 2022, the substantive portion of the visit can be history, physical exam, medical decision-making, or more than half of the total time (except for critical care, which can only be more than half of the total time). By 2023, the substantive portion of the visit will be defined as more than half of the total time spent.

    • Split or shared visits can be reported for new as well as established patients, and initial and subsequent visits, as well as prolonged services.

    • A modifier is required on the claim to identify these services.

    • Documentation in the medical record must identify the two individuals who performed the visit and the person providing the substantive portion must sign and date the medical record.

  • Critical Care Services. The CY 2022 PFS final rule establishes the following:

    • Critical care services are defined in the CPT Codebook prefatory language for the code set.

    • The CPT Codebook listing of bundled services are not separately payable.

    • Medically necessary critical care services can be furnished concurrently to the same patient on the same day by more than one practitioner representing more than one specialty, and critical care services can be furnished as split/shared visits.

    • Critical care services can be paid on the same day as other E/M visits by the same practitioner or another practitioner in the same group of the same specialty, if various conditions are met, including that the E/M visit was provided prior to the critical care service when the patient did not require critical care, the visit was medically necessary, and the services are separate and distinct, with no duplicative elements from the critical care service provided later in the day.

    • Critical care services can be paid in addition to a procedure with a global surgical period if the critical care is unrelated to the surgical procedure. Preoperative and/or postoperative critical care may be paid in addition to the procedure if the patient is critically ill and requires the full attention of the physician, and the critical care is above and beyond and unrelated to the specific anatomic injury or general surgical procedure performed. CMS is creating a new modifier for use on such claims to identify that the critical care is unrelated to the procedure.

  • Teaching Physician Services.  The CY 2022 PFS final rule establishes that only the time spent by the teaching physician in qualifying activities, including time that the teaching physician was present with the resident performing those activities, can be included for purposes of visit level selection. Under the primary care exception, time cannot be used to select visit level.

  • Telehealth Services.  The CY 2022 PFS final rule does the following:

    • Extends through the end of CY 2023, the inclusion of certain services added temporarily to the telehealth services list that would otherwise have been removed from the list as of the later of the end of the COVID-19 Public Health Emergency (PHE) or December 31, 2021;

    • Extends inclusion of certain cardiac and intensive cardiac rehabilitation codes through the end of CY 2023;

    • Implements the statutory amendments requiring that an in-person, non-telehealth visit must be furnished at least every 12 months for the services to continue, that exceptions to the in-person visit requirement may be made based on beneficiary circumstances, and that more frequent visits are also allowed as driven by clinical needs on a case-by-case basis; and

    • Limits the use of an audio-only communications to mental health services furnished by practitioners who have the capability to furnish two-way, audio/video communications, but where the beneficiary is not capable of, or does not consent to, the use of two-way, audio/video technology.

  • Therapy Services.  The CY 2022 PFS final rule does the following:

    • Creates new modifiers so that CMS can identify and make payment for physical therapy and occupational therapy services furnished in whole or in part by physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) at 85% of the otherwise applicable Part B payment amount; and

    • Revises the policy for the de minimis standard.

  • Physician Assistant (PA) Services.  The CY 2022 PFS final rule permits Medicare to make direct payments to PAs for professional services furnished under Part B. Under current law, payments can only be made to the employer or independent contractor of a PA.

  • Vaccine Services.  The CY 2022 PFS final rule:

    • Continues the additional payment of $35.50 for COVID-19 vaccine administration in the home under certain circumstances through the end of the calendar year in which the PHE ends; and

    • Continues to pay for COVID-19 monoclonal antibodies under the Medicare Part B vaccine benefit through the end of the calendar year in which the PHE ends. During this interim time, CMS will also maintain the $450 payment rate for administering a COVID-19 monoclonal antibody in a healthcare setting, as well as the payment rate of $750 for administering a COVID-19 monoclonal antibody therapy in the home.

  • Opioid Treatment Program (OTP).  The CY 2022 PFS final rule:

    • Allows OTPs to furnish counseling and therapy services via audio-only interaction (such as telephone calls) after the conclusion of the COVID-19 PHE in cases where audio/video communication is not available to the beneficiary, including circumstances in which the beneficiary is not capable of or does not consent to the use of devices that permit a two-way audio/video interaction, provided all other applicable requirements are met; and

    • States that CMS is issuing an interim final rule with comment to maintain the payment amount for methadone at the CY 2021 rate for the duration of CY 2022.

Medicare Shared Savings Program (MSSP)
With respect to MSSP, the CY 2022 PFS final rule does the following:

    • Finalizes a longer transition for Accountable Care Organizations (ACOs) to prepare for reporting electronic clinical quality measures/Merit-based Incentive Payment System clinical quality measures (eCQM/MIPS CQM) under the Alternative Payment Model (APM) Performance Pathway (APP). This policy is an effort to respond to ACOs’ concerns about the transition to all-payer eCQM/MIPS CQMs.

    • Finalizes delaying the increase in the quality performance standard ACOs must meet to be eligible to share in savings until performance year (PY) 2024, by maintaining the 30th percentile of the MIPS quality performance category score for PY 2023, and makes additional revisions to the quality performance standard to encourage ACOs to report all-payer measures.

    • Finalizes revisions to the repayment mechanism arrangement policy.

    • Finalizes policies regarding the Shared Savings Program application process by modifying the prior participation disclosure requirement, so that the disclosure is required only at the request of CMS during the application process, and by reducing the frequency and circumstances under which ACOs submit sample ACO participant agreements and executed ACO participant agreements to CMS.

    • Finalizes changes to the beneficiary notification requirement to set forth different notification obligations for ACOs depending on the assignment methodology selected by the ACO to help avoid unnecessary confusion for beneficiaries.

    • Finalizes revisions to the definition of primary care services that are used for purposes of beneficiary assignment. The updated definition will be applicable for determining beneficiary assignment beginning with PY 2022.

    • Summarizes public comments on the MSSP’s benchmarking methodology and risk adjustment methodology. 

Other topics addressed in the final rule include: coverage and payment for medical nutrition therapy and related services, beneficiary coinsurance for additional procedures furnished during the same clinical encounter as a colorectal cancer screening, requirements related to rural health clinics and federally qualified health centers, electronic prescribing of controlled substances, reporting by certain manufacturers of drug pricing information for Part B, the determination of the average sales price of certain self-administered drug products, Part B payments for Section 502(b)(2) drugs, laboratory specimen collection fees and travel allowances, the payment penalty phase of the Appropriate Use Criteria (AUC) program, coverage of pulmonary rehabilitation services, the open payments financial transparency program, Medicare provider enrollment requirements, and the Medicare ground ambulance data collection system.

The final rule is available here. The CMS fact sheet is available here.

Reporter, Dominic Nunneri, Los Angeles, +1 213 443 4329, and Amy O’Neill, Sacramento, +1 916 321 4812,

CMS Issues Final Rule Affecting Home Health, Hospice, Inpatient Rehabilitation Facilities,  and Long-Term Care Facilities for CY 2022 – On November 2, 2021, CMS put on display its final rule that, among other things, updates the home health and home infusion therapy services payment rates for calendar year (CY) 2022; makes significant changes to the provider and supplier enrollment processes and survey and enforcement requirements of hospice programs; finalizes modifications to the effective date for reporting of measures and certain standardized patient assessment data in the Inpatient Rehabilitation Facility (IRF) Quality Reporting program; and makes permanent selected regulatory blanket waivers related to home health aide supervision that were issued to Medicare participating home health agencies during the COVID-19 public health emergency.

Home Health Prospective Payment System (HH PPS)

The final rule provides a summary of comments on Patient-Driven Grouping Model (PDGM) monitoring data and analyses on home health utilization, low utilization payment adjustments (LUPA), and the distribution of the case-mix methodology as determined by clinical groupings, admission sources, and timing, functional status, and comorbidities. The final rule also finalizes the recalibration of the PDGM case-mix weights, functional levels, and comorbidity adjustment subgroups while maintaining the CY 2021 LUPA thresholds for CY 2022. Further, the final rule contains updates to the home health wage index, the national, standardized 30-day period payment rates, and the national per-visit payment amounts by the home health payment update percentage.

Home Health Value Based Purchasing (HHVBP) Model

The final rule finalized CMS’s proposal to expand the HHVBP model to all Medicare-Certified home health agencies across the United States and its territories. However, due to the expansion, and in response to comments, CMS is designating CY 2022 as a pre-implementation year, with CY 2023 as the first performance year and CY 2025 as the first payment year. There will be a maximum payment adjustment of 5 percent, upward or downward. All home health agencies certified to participate in the Medicare program prior to 2022 must participate and would be eligible to receive an annual total performance score based on their CY 2023 performance. The original HHVBP model will end one year early.

Home Health (HH) Quality Reporting Program (QRP)

CMS is finalizing the updates to the HH QRP, to include the removal of one OASIS-based measure, replacement of two claims-based measures with one claims-based quality measure; public reporting of two measures; and revising the compliance date for certain reporting requirements for certain HH QRP reporting requirements.

Changes to the Home Health Conditions of Participation

In the Final Rule, CMS makes permanent selected regulator blanket waivers related to home health aide supervision that CMS extended to Medicare-participating home health agencies during the COVID-19 public health emergency. Additionally, CMS will now permit an occupational therapist to conduct a home health initial assessment visit and complete a comprehensive assessment under the Medicare program when occupational therapy is on the home health plan of care, with either physical therapy or speech therapy and when skilled nursing services are not initially in the plan of care.

Medicare Coverage of Home Infusion Therapy

The final rule contains significant adjustments to the home infusion therapy services payment adjustments, to include updates to the geographic adjustment factors.

Provider and Supplier Enrollment Processes

In addition to the foregoing, CMS, through the final rule, also addresses policies related to: (1) the effective date of billing privileges for certain provider and supplier types and the effective date of certain provider enrollment transactions; and (2) the deactivation of a provider’s or supplier’s billing privileges.

Survey and Enforcement Requirements of Hospice Programs

The final rule enhances the hospice survey process by requiring the use of multidisciplinary survey teams, prohibiting surveyor conflicts of interest, expanding CMS-based surveyor training to accrediting organizations (AOs), and requiring AOs with CMS-approved hospice programs to begin use of the Form CMS-2567; establishing a hospice program complaint hotline, and creating the authority for imposing enforcement remedies for noncompliance hospice programs including the development and implementation of a range of remedies.

Inpatient Rehabilitation Facility (IRF) and Long-Term Care Hospital (LTCH) Quality Reporting Programs

CMS finalized its proposals to modify the compliance date for certain reporting requirements in the IRF and LTCH QRPs.

COVID-19 Reporting Requirements for Long-Term Care (LTC) Facilities

CMS finalized COVID-19 reporting requirements, with certain modifications: reporting frequency to be no more than weekly, the required date elements may be modified in the future at the discretion of the Secretary, and the reporting requirements will sunset as of December 31, 2024.

The final rule is scheduled to be printed in the Federal Register on November 9, 2021. A display copy is available here. The CMS fact sheet is available here.

Reporter, Christopher C. Jew, Los Angeles, + 1 213 443 4336,

Monthly Editors: Isabella Wood and Amy O’Neill.