SNF PPS Final Rule
The Centers for Medicare and Medicaid Services (CMS) has issued the Final Rule for the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) changes effective with the Oct. 1, 2013 start of the 2014 federal fiscal year. The Final Rule as posted in the Federal Register can be viewed by clicking here.
Our initial analysis shows that the Final Rule is fairly consistent with the Proposed Rule. One important change to note is that the final net market basket update of 1.3 percent is slightly lower than the 1.4 percent originally proposed due to an increase in the Multifactor Productivity Factor (MPF) from 0.4 to 0.5 percent. This net market basket rate adjustment reflects a full market basket increase of 2.3 percent, less the 0.5 percent MFP required by Section 3401(b) of the Affordable Care Act (ACA), and a 0.5 percent adjustment to correct for an error in forecasting the market basket in FY 2012. CMS estimates that the net market basket update overall will increase SNF payments by approximately $470 million in FY 2014 or an average of about $7 per Medicare patient day.
CMS summarizes the Final Rule programmatic changes as including:
- Revision and rebasing of the SNF market basket;
- Updates to the labor related share;
- A new policy for reporting the SNF market basket forecast error in certain limited circumstances;
- A new item to the Minimum Data Set (MDS), Version 3.0 for reporting the number of distinct therapy days; and
- Adoption of changes to the diagnosis code used to determine which residents will receive the AIDS add-on payment, effective for services provided on or after the Oct. 1, 2014 implementation date for conversion to ICD-10-CM.
LeadingAge and LeadingAge NY are now in the process of reviewing the rule and we will provide members with a detailed analysis.
Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827