Federal Register - October 4, 2021
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Source: Federal Register
54635
Federal Register / Vol. 86, No. 189 / Monday, October 4, 2021 / Rules and Regulations TABLE 18FY 2022 IPF PPS FINAL PAYMENT IMPACTSContinued Percent change in columns 3 through 5
Number of facilities
Outlier
FY 2022 wage index, LRS, and COLA
Total percent change 1
Facility by type FY 2019
claims Non-Profit
For-Profit
Rural Psychiatric Hospitals:
Government
Non-Profit
For-Profit
IPF Units:
Urban:
Government
Non-Profit
For-Profit
Rural:
Government
Non-Profit
For-Profit
By Teaching Status:
Non-teaching
Less than 10% interns and residents to beds
10% to 30% interns and residents to beds
More than 30% interns and residents to beds
By Region:
New England
Mid-Atlantic
South Atlantic
East North Central
East South Central
West North Central
West South Central
Mountain
Pacific
By Bed Size:
Psychiatric Hospitals:
Beds: 024
Beds: 2549
Beds: 5075
Beds: 76 +
Psychiatric Units:
Beds: 024
Beds: 2549
Beds: 5075
Beds: 76 +
FY 2020
claims
FY 2019
claims
FY 2020
claims
FY 2019
claims
FY 2020
claims
FY 2019
claims
FY 2020
claims
95
270
97
278
0.1
0.0
0.5
0.1
0.2
0.1
0.1
0.1
1.8
2.1
1.4
2.0
31
12
17
32
12
17
0.1
0.1
0.0
0.8
1.2
0.0
0.5
0.1
0.4
0.6
0.0
0.4
2.5
1.8
2.4
1.8
0.7
2.4
108
480
152
107
478
152
0.4
0.2
0.1
3.4
1.7
0.7
0.1
0.1
0.1
0.1
0.1
0.1
1.8
1.7
1.8
1.4
0.2
1.2
58
132
49
57
131
50
0.0
0.1
0.1
0.4
1.0
0.6
0.4
0.1
0.2
0.3
0.1
0.2
2.3
1.9
1.7
1.9
1.0
1.2
1,322
109
67
22
1,336
109
67
22
0.1
0.2
0.3
0.4
0.8
1.9
2.4
3.2
0.0
0.1
0.1
0.1
0.0
0.1
0.1
0.1
1.9
1.9
1.6
1.5
1.1
0.2
0.5
1.3
106
215
240
243
152
108
224
103
129
106
216
243
244
155
109
227
103
131
0.2
0.2
0.1
0.1
0.1
0.2
0.1
0.1
0.2
1.2
2.0
0.7
0.7
0.7
1.4
0.5
0.7
1.4
0.4
0.2
0.6
0.2
0.5
0.1
0.3
0.2
0.4
0.4
0.2
0.6
0.2
0.5
0.1
0.3
0.3
0.4
1.5
1.6
2.5
1.7
1.4
2.0
1.7
2.2
2.3
0.3
0.2
1.9
1.0
0.7
0.7
1.3
1.6
1.0
83
79
84
295
88
83
88
300
0.1
0.0
0.0
0.0
0.5
0.2
0.1
0.4
0.1
0.3
0.1
0.1
0.0
0.3
0.2
0.1
2.0
1.7
2.1
2.1
1.5
1.5
2.2
1.7
536
259
114
70
531
259
114
71
0.2
0.2
0.2
0.3
1.2
1.3
2.0
2.5
0.0
0.0
0.3
0.0
0.0
0.0
0.3
0.0
1.8
1.9
1.5
1.8
0.7
0.7
0.3
0.5
1 This column includes the impact of the updates in columns 3 and 4 above, and of the final IPF market basket increase factor for FY 2022 2.7 percent, reduced by 0.7 percentage point for the productivity adjustment as required by section 1886s2Ai of the Act. Note, the products of these impacts may be different from the percentage changes shown here due to rounding effects.
16. On page 42675 in the first column, in the second full paragraph, a. In line 2, remove the number 1,519 and add in its place 1,520.
b. In line 6, remove 1.9 percent and add in its place 2.1 percent.
17. On page 42675, in the second column, a. In the first full paragraph, 1 In line 5, remove the sentence, Based on the FY 2019 claims, the estimated change in total IPF payments for FY 2022 would include an approximate 0.1 percent increase in payments because we would expect the outlier portion of total payments to increase from approximately 1.9 percent to 2.0 percent.
and add in its place, Based on the FY 2019 claims, the estimated change in total IPF payments for FY 2022 would include an approximate 0.1 percent decrease in
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payments because we would expect the outlier portion of total payments to decrease from approximately 2.1
percent to 2.0 percent.
2 In the second full paragraph and continuing into the first paragraph of the third column, remove the paragraph, The overall impact of the estimated increase or decrease to payments due to updating the outlier fixed dollar loss threshold as shown in column 3 of Table 18, across all hospital groups, is 0.1 percent based on the FY 2019 claims, or 1.1
percent based on the FY 2020 claims. Based on the FY 2019 claims, the largest increase in payments due to this change is estimated to be 0.4 percent for teaching IPFs with more than 30 percent interns and residents to beds.
Among teaching IPFs, this same provider facility type would experience the largest estimated decrease in payments if we were to instead increase the outlier fixed dollar loss threshold based on the FY 2020 claims distribution.
and add in its place
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The overall impact of the estimated decrease to payments due to updating the outlier fixed dollar loss threshold as shown in column 3 of Table 18, across all hospital groups, is a 0.1 percent decrease based on the FY 2019 claims, or a 1.1 percent decrease based on the FY 2020 claims. Based on the FY 2019 claims, the largest decreases in payments due to this change are estimated to be 0.4 percent for urban government IPF
units and 0.4 percent for teaching IPFs with more than 30 percent interns and residents to beds. These same provider facility types would also experience the largest estimated decreases in payments if we were to instead increase the outlier fixed dollar loss threshold based on the FY 2020 claims distribution.
18. On page 42676, a. In the first column, in the first full paragraph, remove the paragraph, Finally, column 5 compares the total final changes reflected in this final rule for FY
2022 to the estimates for FY 2021 without these changes. The average estimated
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