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CMS recently published the FY 2026 Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Proposed Rule which proposed changes to the Inpatient Psychiatric Facility Quality Reporting (IPFQR) program. All IPFs, which include psychiatric hospitals and psychiatric units of an acute care hospital or critical access hospital, paid under the IPF PPS must meet IPFQR reporting requirements. For the full text of the proposed rule, see the Federal Register.
Inpatient Psychiatric Facilities Prospective Payment System
In this proposed rule, CMS has not proposed the addition of any new measures. CMS, has however, proposed the removal of 4 measures beginning with CY 2024 reporting period (FY 2026 payment determination): the COVID-19 Vaccination Coverage Among Healthcare Personnel (HCP) measure; the Facility Commitment to Health Equity (FCHE) measure; and the two Social Drivers of Health measures, the Screening for Social Drivers of Health (SDOH-01) and Screen Positive Rate for Social Drivers of Health (SDOH-02). These measures are proposed for removal due to the costs associated with each measure outweighing the benefit of the measure’s continued use in the program. Please note, the proposed rule states removal of the SDOH measures beginning with FY 2026 determination period; however, these measures were previously finalized as voluntary for 2024 reporting and mandatory beginning with CY 2025 reporting period (FY 2027 payment determination).
CMS also proposed modifying the reporting period of the 30-Day Risk-Standardized All Cause Emergency Department (ED) Visit Following an IPF Discharge measure beginning with the FY 2027 payment determination. CMS proposed to modify the current 1-year reporting period for the IPF ED Visit measure to a 2-year reporting period to align with the IPF Unplanned Readmission measure reporting period. The 2-year reporting period would run from July 1st, 4 years prior to the applicable fiscal year payment determination, to June 30th, 2 years prior to the applicable fiscal year payment determination. This would make the first reporting period for the measure Q3 CY 2025 – Q2 Cy 2027 for the FY 2029 payment determination.
Lastly, CMS proposed updates to the Extraordinary Circumstances (ECE) policy. CMS proposed that an IPF may request an ECE within 30 calendar days of the date that the extraordinary circumstance occurred. The current policy allows a request within 90 days, but this proposed change aligns the IPFQR Program policy with other CMS quality programs. CMS proposed that CMS notify the requestor with a decision in writing, via email, and will include if the IPF is exempted from one or more reporting requirements or if the IPF is granted an extension of time to comply with one or more reporting requirements.
Looking ahead, CMS is soliciting feedback on a potential future star rating system for IPFs. Although IPFQR reported data is publicly reported on the Compare tool on Medicare.gov, there are no star ratings displayed for IPFs and IPFs are not included in hospital star ratings. CMS is also interested in feedback to inform future measure development for the IPFQR Program, as CMS’ goal is to re-focus on measurable clinical outcomes and identify quality
If you have questions about your IPF PPS reporting, please contact us.