On April 20, 2015, CMS published its proposed rule updating Medicare skilled nursing facility (SNF) PPS rates and policies for FY 2016. CMS projects that the proposed rule would increase overall payments to SNFs by $500 million, or 1.4%, compared to FY 2015 levels. This update would be attributed to a 2.6% market basket increase that would be reduced by a 0.6 percentage point forecast error adjustment and a 0.6 percentage point multifactor productivity adjustment.
The proposed rule also would implement a provision of the
Improving Medicare Post-Acute Care Transformation Act of 2014
(IMPACT Act) that reduces, by two percentage points, the annual
update to SNFs that fail to submit required quality data to CMS
under the SNF Quality Reporting Program (QRP), beginning with FY
2018. CMS is proposing to adopt three measures SNFs would be
required to report beginning with the FY 2018 SNF QRP that address
three quality domains identified in the IMPACT Act: (1) skin
integrity and changes in skin integrity; (2) incidence of major
falls; and (3) functional status, cognitive function, and changes
in function and cognitive function. The proposed measures are
intended to address the IMPACT Act requirement of standardized
post-acute care data reporting across home health agencies,
inpatient rehabilitation facilities, long term care hospitals, and
SNFs. CMS intends to propose additional quality measures and
resource use measures in future rulemaking.
Additionally, CMS proposes establishing a 30-day all-cause,
all-condition hospital readmission quality measure that will be
used in a new SNF Value-Based Purchasing (VBP) Program beginning
with FY 2019, as required by the Protecting Access to Medicare Act
of 2014 (PAMA). CMS notes that PAMA also requires CMS to specify an
all-condition, risk-adjusted potentially preventable hospital
readmission rate, which CMS intends to address in future
rulemaking. CMS also seeks comments on numerous issues associated
with the SNF VBP Program, which will be addressed in the FY 2017
SNF PPS proposed and final rules. In addition, the proposed rule
would establish new regulatory reporting requirements for SNFs and
nursing facilities to electronically submit staffing information
based on payroll data, as mandated by the Affordable Care Act
(ACA).
Comments on the proposed rule will be accepted until June 15, 2015.
This article is presented for informational purposes only and is not intended to constitute legal advice.