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Federal Register / Vol. 86, No. 147 / Wednesday, August 4, 2021 / Rules and Regulations FY 2024 payment determination and subsequent years:
++ Alcohol Use Brief Intervention Provided or Offered and Alcohol Use
Brief Intervention Provided SUB2/2a measure; and
FY 2022 IPF PPS
payment update
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II. Background A. Overview of the Legislative Requirements of the IPF PPS
Section 124 of the Medicare, Medicaid, and State Childrens Health Insurance Program Balanced Budget Refinement Act of 1999 BBRA Pub. L.
106113 required the establishment and implementation of an IPF PPS.
Specifically, section 124 of the BBRA
mandated that the Secretary of the Department of Health and Human Services the Secretary develop a per diem Prospective Payment System PPS
for inpatient hospital services furnished in psychiatric hospitals and excluded psychiatric units including an adequate patient classification system that reflects the differences in patient resource use and costs among psychiatric hospitals and excluded psychiatric units.
Excluded psychiatric unit means a psychiatric unit of an acute care hospital or of a Critical Access Hospital CAH, which is excluded from payment under the Inpatient Prospective Payment System IPPS or CAH
payment system, respectively. These excluded psychiatric units will be paid under the IPF PPS.
Section 405g2 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 MMA Pub.
L. 108173 extended the IPF PPS to psychiatric distinct part units of CAHs.
Sections 3401f and 10322 of the Patient Protection and Affordable Care Act Pub. L. 111148 as amended by section 10319e of that Act and by section 1105d of the Health Care and Education Reconciliation Act of 2010
Pub. L. 111152 hereafter referred to jointly as the Affordable Care Act
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Total Transfers & Cost Reductions The overall economic impact of this final rule is an estimated $80
million in increased payments to IPFs during FY 2022.

The overall economic impact of the IPFQR Program provisions of this final rule is an estimated $512,065
reduction in information collection burden.

added subsection s to section 1886 of the Act.
Section 1886s1 of the Act titled Reference to Establishment and Implementation of System, refers to section 124 of the BBRA, which relates to the establishment of the IPF PPS.
Section 1886s2Ai of the Act requires the application of the productivity adjustment described in section 1886b3BxiII of the Act to the IPF PPS for the rate year RY
beginning in 2012 that is, a RY that coincides with a FY and each subsequent RY.
Section 1886s2Aii of the Act required the application of an other adjustment that reduced any update to an IPF PPS base rate by a percentage point amount specified in section 1886s3 of the Act for the RY
beginning in 2010 through the RY
beginning in 2019. As noted in the FY
2020 IPF PPS final rule, for the RY
beginning in 2019, section 1886s3E
of the Act required that the other adjustment reduction be equal to 0.75
percentage point; this was the final year the statute required the application of this adjustment. Because FY 2021, was a RY beginning in 2020, FY 2021 was the first-year section 1886s2Aii did not apply since its enactment.
Sections 1886s4A through D of the Act require that for RY 2014 and each subsequent RY, IPFs that fail to report required quality data with respect to such a RY will have their annual update to a standard Federal rate for discharges reduced by 2.0 percentage points. This may result in an annual update being less than 0.0 for a RY, and may result in payment rates for the upcoming RY being less than such
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payment rates for the preceding RY.
Any reduction for failure to report required quality data will apply only to the RY involved, and the Secretary will not take into account such reduction in computing the payment amount for a subsequent RY. More information about the specifics of the current Inpatient Psychiatric Facilities Quality Reporting IPFQR Program is available in the FY
2020 IPF PPS and Quality Reporting Updates for Fiscal Year Beginning October 1, 2019 final rule 84 FR 38459
through 38468.
To implement and periodically update these provisions, we have published various proposed and final rules and notices in the Federal Register. For more information regarding these documents, see the Center for Medicare & Medicaid CMS
website at https www.cms.gov/
Medicare/Medicare-Fee-for-ServicePayment/InpatientPsychFacilPPS/
index.html?redirect=/
InpatientPsychFacilPPS/.
B. Overview of the IPF PPS
The November 2004 IPF PPS final rule 69 FR 66922 established the IPF
PPS, as required by section 124 of the BBRA and codified at 42 CFR part 412, subpart N. The November 2004 IPF PPS
final rule set forth the Federal per diem base rate for the implementation year the 18-month period from January 1, 2005 through June 30, 2006, and provided payment for the inpatient operating and capital costs to IPFs for covered psychiatric services they furnish that is, routine, ancillary, and capital costs, but not costs of approved educational activities, bad debts, and
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ER04AU21.169

FY 2023 IPFQR
Program update.

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++ Tobacco Use Treatment Provided or Offered and Tobacco Use Treatment TOB2/2a measure.
C. Summary of Impacts
Provision Description
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