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September 2020 Update

Congress Returns after August Recess

The 116th Session of Congress will end in December, giving lawmakers only four months to wrap up legislation business. Leaders are facing the challenge of addressing the COVID-19 pandemic while also trying to maintain normal legislative business, such as annual appropriations and expiring provision, all within the backdrop of a Presidential election looming over every decision. Congress returns in late August to a host of pressing issues, including how to come to agreement on a new COVID-19 stimulus/ support package. Lawmakers were unable to come to agreement on the next COVID-19 package before the August recess. In addition, the FY 2020 is over at the end of September and Congress will have to come to an agreement on FY 2021 spending bills or face a government shutdown. It’s very likely that Congress will pass a Continuing Resolution to maintain FY 2020 spending levels until after the elections rather than try to pass updated spending bills before the end of September.

CMS Issues Final Rule on Inpatient Rehabilitation Facility Prospective Payment System for FY 2021

The final rule for the IRF Prospective Payment System was released on August 10th and included a final ruling on CMS’s proposal to allow the use of non-physician practitioners (NPPs) to perform the IRF services and documentation requirements that now must be done by rehabilitation physicians. This expanded scope of practice proposal was opposed by a number of physician groups, including the American Medical Association, AAPM&R and AAP. Over 122 groups signed comments to CMS urging them not to move forward with the proposal, telling CMS that NPPs' skill set is not interchangeable with that of fully-trained rehabilitation physicians’ and explaining that if the proposal moved forward it could reduce the standard and quality of care IRF patients receive.

The Final Rule did not finalize CMS’s initial proposal, but instead moved forward with a compromised approached. Currently, CMS requires physicians to conduct visits three days per week in order to certify a patient’s plan of care. NPPs can perform those visits as it stands now, but those visits do not fulfil the three visit requirement. However, under the Final Rule, NPPs are allowed to conduct one of the three required visits, if permitted under state law, with the exception of the first week.


Update provided by Bryan Cave Leighton Paisner LLP






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