{"abstract":"This proposed rule would update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2019. As required by the Social Security Act (the Act), this proposed rule includes the classification and weighting factors for the IRF prospective payment system's (PPS) case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2019. We are also proposing to alleviate administrative burden for IRFs by removing the Functional Independence Measure (FIM<SUP>TM</SUP>) instrument and associated Function Modifiers from the IRF Patient Assessment Instrument (IRF-PAI) and revising certain IRF coverage requirements to reduce the amount of required paperwork in the IRF setting. In addition, we are soliciting comments on removing the face-to-face requirement for rehabilitation physician visits and expanding the use of non-physician practitioners (that is, nurse practitioners and physician assistants) in meeting the IRF coverage requirements. For the IRF Quality Reporting Program (QRP), we are proposing to adopt a new measure removal factor, remove two measures from the IRF QRP measure set, and codify in our regulations a number of requirements.","action":"Proposed rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2018/05/08/2018-08961.html","cfr_references":[{"chapter":null,"citation_url":null,"part":412,"title":42}],"citation":"83 FR 20972","comment_url":null,"comments_close_on":"2018-06-26","correction_of":null,"corrections":[],"dates":"To be assured consideration, comments must be received at one of the addresses provided below, not later than 5 p.m. on June 26, 2018.","disposition_notes":null,"docket_ids":["CMS-1688-P"],"dockets":[{"supporting_documents":[],"agency_name":"CMS","documents":[{"comment_count":114,"comment_start_date":"2018-05-08","updated_at":"2023-02-28T14:54:45.950-05:00","comment_url":"https://www.regulations.gov/commenton/CMS-2018-0050-0003","allow_late_comments":null,"id":"CMS-2018-0050-0003","comment_end_date":"2018-06-27","regulations_dot_gov_open_for_comment":false}],"supporting_documents_count":0,"id":"CMS-2018-0050","title":"Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2019 (CMS-1688-P)"}],"document_number":"2018-08961","effective_on":null,"end_page":21015,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2018/05/08/2018-08961.xml","html_url":"https://www.federalregister.gov/documents/2018/05/08/2018-08961/medicare-program-inpatient-rehabilitation-facility-prospective-payment-system-for-federal-fiscal","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/2018-08961?publication_date=2018-05-08","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2018-05-08/2018-08961/mods.xml","not_received_for_publication":null,"page_length":44,"page_views":{"count":8939,"last_updated":"2026-10-22 16:15:06 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2018-05-08/pdf/2018-08961.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2018-08961.pdf?1524860118","publication_date":"2018-05-08","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2018/05/08/2018-08961.txt","regulation_id_number_info":{"0938-AT25":{"issue":"201804","html_url":"https://www.federalregister.gov/regulations/0938-AT25/inpatient-rehabilitation-facility-prospective-payment-system-for-federal-fiscal-year-2019-cms-1688-p","title":"Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2019 (CMS-1688-P)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201804&RIN=0938-AT25&operation=OPERATION_EXPORT_XML","priority_category":"Economically Significant"}},"regulation_id_numbers":["0938-AT25"],"regulations_dot_gov_info":{"supporting_documents":[],"regulatory_plan":{"html_url":"https://www.federalregister.gov/regulations/0938-AT25/inpatient-rehabilitation-facility-prospective-payment-system-for-federal-fiscal-year-2019-cms-1688-p","title":"Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2019 (CMS-1688-P)"},"comments_count":114,"agency_id":"CMS","comments_url":"https://www.regulations.gov/docketBrowser?rpp=50&so=DESC&sb=postedDate&po=0&dct=PS&D=CMS-2018-0050","supporting_documents_count":0,"docket_id":"CMS-2018-0050","document_id":"CMS-2018-0050-0003","regulation_id_number":"0938-AT25","title":"Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2019 (CMS-1688-P)","checked_regulationsdotgov_at":"2023-02-28T19:54:45Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":20972,"subtype":null,"title":"Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2019","toc_doc":"Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2019","toc_subject":"Medicare Program:","topics":["Administrative practice and procedure","Health facilities","Medicare","Puerto Rico","Reporting and recordkeeping requirements"],"type":"Proposed Rule","volume":83}