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Connection Newsletter - CMS releases proposed FY 2023 PPS rules

In addition to releasing two proposed rules, CMS updated its guidance on compliance with COVID-19 vaccination requirements.

Legislative update

Action at the state capitol was extremely slow this week—in fact, the House only gaveled in for two of their four workdays. The Senate continued to meet each day, although the agendas were short. We can expect this pattern to continue while leadership continues to negotiate on the budget. We are swiftly approaching the 100-day mark for the session—only 13 days until that deadline. Once we reach the 100-day mark, leadership may extend the session by seven days, and thereafter a majority vote of both chambers is required to continue to do business. Ultimately, around 400 of the nearly 1800 bills introduced are still in play for this year, although not all of them will become law.

While we are still in legislative session, this week also marked an important deadline for the 2022 election taking place this fall. Signatures were due to the Secretary of State to qualify for the ballot, and pending any litigation over signature verification, we know who is running for reelection and who isn’t. In nearly half of the Arizona Senate races, the entire race is in the primary since no candidate from the opposing party is even running. The same is true in several House districts, although they don’t match the unopposed Senate districts. No matter what happens in November, both the Republicans and Democrats will have a guaranteed seven Senate seats and 21 and 17 House seats, respectively, when the 56th Legislature convenes in January 2023.

CMS releases proposed FY 2023 IRF PPS rule

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule last week for the inpatient rehabilitation facility prospective payment system (IRF PPS) for fiscal year (FY) 2023 that would increase payments by a net 2.8% relative to FY 2021. CMS also proposes to require IRFs to collect quality data on all patients, regardless of payer, beginning October 2023. The agency estimates that the additional reporting burden will cost IRFs over $31 million per year (an average of nearly $29,000 per IRF).

CMS also proposes to cap wage index decreases at 5% to mitigate instability in IRF PPS payments; and seeks comments on potential changes to the IRF transfer payment policy, facility-level adjustment factors and IRF teaching status adjustment policy.

AzHHA members should be on the lookout for a more detailed analysis of the proposed rule in the coming days, including facility-specific estimated impacts. CMS is accepting comments on the rule until 5 p.m. on May 31.

CMS releases proposed FY 2023 IPF PPS rule

In addition to releasing the IRF PPS rule, CMS also issued a proposed rule for the inpatient psychiatric facility prospective payment system (IPF PPS) for FY 2023. CMS proposes to increase IPF payments by a net 2.7%. The rule does not propose any changes to the IPF Quality Reporting Program, but CMS requests feedback on how it may use measurement and stratification as tools to address healthcare disparities.

CMS also proposes to cap wage index decreases at 5% to mitigate instability in IPF PPS payments; and solicits comments on refinements to the adjustment model used to calculate IPF PPS payments.

AzHHA members will receive a more detailed analysis of the proposed rule in the coming days, including facility-specific estimated impacts. CMS is accepting comments on the rule through May 31.

Updated CMS guidance on compliance with COVID-19 vaccination requirement

CMS updated its guidance Wednesday for compliance with the agency’s COVID-19 vaccination requirement for healthcare staff. The updated guidance, which is effective immediately, provides additional information related to surveying for the vaccination status of contracted services employees and clarifies when it is appropriate for surveyors to look for compliance with the COVID-19 vaccination requirement.

Black Maternal Health Week starts Monday

April 11 kicks off Black Maternal Health Week, a great opportunity to create awareness and deepen the conversation about Black maternal care. The work in improving maternal health does not end in a week, it is an ongoing effort. Join AzHHA in its first Arizona AIM Collaborative conference May 26 where we will be hosting a virtual screening of Toxic: A Black Woman’s Story,” a film that helps explore the many underlying factors, such as toxic stress, racial inequities, unconscious bias and microaggressions, impacting the health of Black women and their birth outcomes. Following the screening, conference attendees will engage in a breakout session facilitated by Arizona, maternal health experts to unfold the issues critical to improving maternal health equity. To register for the conference, click here.

Calling rural hospitals - Join the Arizona Health Equity Organizational Assessment Collaborative

AzHHA has teamed up with key stakeholders statewide to reduce healthcare disparities in rural Arizona. We invite rural hospitals, federally qualified health centers (FQHCs) and post-acute care facilities to be a part of this exciting initiative called the Arizona Health Equity Organizational Assessment (HEOA) Collaborative.

As we work through the effects of the COVID-19 pandemic in our communities—and with our healthcare workforce—the HEOA Collaborative will focus on incorporating an equity lens for quality, patient safety and population health to improve the patient experience and health outcomes for people experiencing various health conditions, such as COVID-19.

Participating facilities will have access to monthly collaboration calls to hear about new resources and share best practices. Facilities will also receive technical assistance to implement tools and processes identified by the HEOA Collaborative. Learn more about the program and download the enrollment forms at

Sotrovimab no longer authorized to treat COVID-19

As the Omicron BA.2 variant surpasses 50% of COVID-19 cases on all Health and Human Services (HHS) U.S. regions, the U.S. Food and Drug Administration (FDA) updated Sotrovimab’s emergency use authorization. The monoclonal antibody is no longer authorized in any U.S. state or territory at this time because it is unlikely to work against the predominating BA.2 variant. Healthcare providers should use other approved or authorized products as they choose appropriate treatment options for patients.

The FDA will continue to monitor BA.2 in all U.S. regions and will provide follow-up communication when appropriate.

Rule is proposed to make coverage more affordable by fixing the ACA ‘family glitch’

The Department of Treasury proposed updated regulations that would enable more families to access health insurance subsidies on the Health Insurance Marketplace. The proposal would eliminate the “family glitch” that inaccurately assessed the affordability of coverage — and therefore eligibility for Marketplace subsidies — for certain families.


Upcoming Events

Introduction to POLST

Interested in learning how to use the Arizona POLST form with your patients? The one-hour Introduction to POLST workshop equips healthcare professionals with knowledge and resources to begin using POLST, Physician Orders for Life-Sustaining Treatment, in Arizona. The objectives are to describe what POLST is at the state and national level, explain why POLST is important, define the population for POLST, when to begin the conversation and who completes POLST, describe the process for completing, reviewing and updating POLST and learn the process of submitting healthcare planning documents to the Arizona Healthcare Directive Registry. To register for a workshop, click on a date below.

May 7 - Communication in Serious Illness Workshop

The objectives for this 2.5-hour didactic session are to review the need for a systematic approach to having more, better and earlier conversations about patient values and priorities in serious illness, defining a population with serious illness for whom improved communication holds many benefits, applying a structured communication tool to facilitate communication with patients with serious illness, and reviewing the value of summarizing, follow up and documentation. Learn more and register here.

May 26 - 2022 Arizona AIM Collaborative Conference

Reserve your seat for the 2022 AIM Collaborative virtual conference held May 26. This year’s conference theme, A Push for Change, will focus on the Alliance for Innovation on Maternal Health (AIM)’s maternal hypertension bundle. Attendees will learn about the newest evidence and strategies for timely treatment of hypertensive disorders of pregnancy and integration of health equity into patient care. Register for the free, virtual conference here by May 18.

June 14 – Annual Arizona Rural Health Conference

For the past 47 years, the Arizona Center for Rural Health has hosted the Annual Arizona Rural Health Conference in collaboration with the Arizona Rural Health Association, making it one of the longest continually running rural health conferences in the United States. The Arizona Rural Health Conference provides an environment for networking and dissemination of pertinent information among professionals and community members from rural Arizona and the Southwest. Register here.

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