Major Advocacy Win! Removal of Post-Admission Physician Evaluation (PAPE)
On August 4, 2020, CMS decided to remove the post-admission physician evaluation (PAPE) documentation requirement, effective October 1, 2020, as part of its Inpatient Rehabilitation Facility (IRF) Prospective Payment System Final Rule for 2021.
AAPM&R has long advocated to reduce burden for physiatrists by streamlining administrative documentation. Since 2013, our Health Policy and Legislation Committee has been advocating to revise redundant documentation requirements in IRFs, between the pre-admission screening, the previously required PAPE, and individualized overall plan of care (IPOC). IRFs have more documentation requirements than other settings and IRF admissions are often deemed unnecessary by Medicare auditors based on technical errors in documentation, rather than the patient’s actual medical need for an IRF admission. With one fewer documentation requirement in IRFs, physiatrists will be able to spend more time caring for their patients rather than ensuring redundant documentation is completed in tight timelines.
CMS’ decision to remove the PAPE is a direct result of our persistent advocacy*.
As proposed, CMS also codified into regulation certain elements of the pre-admission screening (PAS); however, they have removed three elements from the Medicare Benefit Policy Manual including expected frequency and duration of treatment in the IRF, any anticipated post-discharge treatments, and other information relevant to the patient’s care needs.