Proposed Rule Would Update Skilled Nursing Facilities Payments for FY 2020

Posted on May 01, 2019

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the Medicare fee-for-service prospective payment system for skilled nursing facilities (SNFs) for fiscal year (FY) 2020. Highlights of the proposed rule, which take effect Oct. 1 unless otherwise noted, include:

  • Excluding budget neutrality, the proposal includes a net 2.5% marketbasket increase after the 3% marketbasket increase is reduced by the 0.5 percentage point productivity adjustment. Facilities that fail to comply with reporting requirements for the FY 2020 SNF quality reporting program (QRP) would be subject to a 2 percentage point reduction to the marketbasket update.
  • Implementation of the new patient-driven payment model, which bases payments on a composite profile of patients, rather than volume of therapy services. This new model was finalized in the FY 2019 SNF final rule and is expected to improve payments to hospital-based SNFs.
  • Expansion of data collection for SNF QRP measures to all SNF residents, regardless of their payer.
  • Adoption of two new process measures for the FY 2022 SNF QRP:
    • The “Transfer of Health Information to the Provider — Post Acute Care” measure would assess whether a current reconciled medication list is given to the subsequent provider when a patient is discharged or transferred from a SNF to another facility.
    • The “Transfer of Health Information to the Patient — Post Acute Care” would assess whether a current reconciled medication list is provided to the patient, family or caregiver when the patient is discharged from a SNF to a private home.

In the coming weeks, the MHA will provide additional information regarding the proposed rule, including a facility-specific impact analysis. The association will also make its draft comments available and encourages members to submit their comments to the CMS prior to the June 18 due date. Members with questions should contact Vickie Kunz at the MHA. 

Tags: proposed rule, CMS, SNF

Posted in: Member News

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