H.J. Res. 216 is a joint resolution that would disapprove of a rule submitted by the Centers for Medicare & Medicaid Services (CMS) relating to the Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2025 and Updates to the IRF Quality Reporting Program.
The rule, which was published in the Federal Register on October 21, 2022, would make a number of changes to the Medicare Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program (QRP).
The PPS is a payment system that determines how much Medicare pays hospitals for inpatient rehabilitation services. The QRP is a program that collects data on the quality of care provided by IRFs.
The changes proposed in the rule include:
- Updating the payment rates for IRFs for FY 2025.
- Revising the criteria for determining which patients are eligible for IRF services.
- Making changes to the QRP, including adding new measures and revising existing measures.
Arguments in favor of the resolution:
- The resolution would prevent the rule from going into effect, which would protect Medicare beneficiaries from cuts to their access to IRF services.
- The rule is based on flawed data and would result in lower payments to IRFs, which would force some IRFs to close and reduce access to care for Medicare beneficiaries.
- The rule would make it more difficult for patients to qualify for IRF services, which would delay or deny needed care.
Arguments against the resolution:
- The rule is necessary to update the IRF PPS and QRP and ensure that Medicare is paying for high-quality care.
- The rule would make the IRF PPS more equitable and would encourage IRFs to provide more efficient and effective care.
- The rule would improve the quality of care provided by IRFs by adding new measures to the QRP and revising existing measures.
The resolution was introduced by Rep. Ami Bera (D-CA) on November 17, 2022. It has been referred to the House Committee on Energy and Commerce.
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