News Alert: CMS Posts 2019 IPPS Final Rule, Heralding Major Changes to Admission Order Regulation

Changes to the inpatient admission order regulations are significant 

The Centers for Medicare & Medicaid Services (CMS) has posted the 2019 Inpatient Prospective Payment (IPPS) Final Rule, which changes inpatient admission order regulations.

The Final Rule was published Thursday in the Federal Register.

“The inpatient admission order regulations are a welcome change for hospitals,” said Ronald Hirsch, MD, in an email to RACmonitor.

“For many reasons, it is still crucial to get the admission order and ensure it is authenticated in a timely manner.”

According to CMS, the Final Rule for fiscal year 2019 updates Medicare payment policies and rates under the IPPS and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) Final Rule.

In its posting, CMS said the set of changes:

• Sets a new performance-based scoring methodology for the Medicare Promoting Interoperability Program, with a smaller set of objectives that will provide a more flexible, less-burdensome structure;
  
• Requires the use of 2015 edition CEHRT for eligible hospitals and critical access hospitals (CAHs) beginning in 2019;
  
• Finalizes an electronic health record (EHR) reporting period of any consecutive 90-day period for new and returning CMS or state Medicaid agency participants in 2019 and 2020;
  
• Finalizes changes to measures and removes certain measures that do not emphasize interoperability and the electronic exchange of health information beginning in 2020; and
  
• Requires eligible hospitals and CAHs to select one quarter of 2019 data during the EHR reporting period and choose at least four self-selected electronic clinical quality measures (eCQMs) from a set of 16 for eCQM reporting. 

Program Note:

Listen to Dr. Hirsch on Monitor Mondays this coming Monday as he continues his reporting on the 2019 IPPS Final Rule.

Click here to read the Final Rule