SNF Prospective Payment System Proposed Rule for 2015
As highlighted in the May 13 edition of Intelligence, the Centers for Medicare and Medicaid Services (CMS) has posted the Notice of Proposed Rulemaking (NPRM) for the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for federal fiscal year 2015 in the May 6 edition of the Federal Register. LeadingAge has developed an Excel™ rate tool that members can use to calculate the potential financial impact of the proposed rule.
Some initial highlights of the proposed rule include:
- A 2.4 percent market basket increase minus a 0.4 percent multifactor productivity adjustment for a net increase of 2.0 percent in SNF PPS rates;
- A zero market basket forecast error adjustment;
- An overall $750M dollar increase in aggregate SNF PPS payments;
- A rebasing of the SNF market basket from 2004 to 2010;
- Adoption of the most recent Office of Management and Budget standards for determining the urban versus rural status of a facility, with a blended implementation phase in; and
- An update to the wage index to reflect hospital wage data for the period of Oct. 1, 2010 to Oct. 1, 2011.
In addition, there are proposed changes in Minimum Data Set (MDS) policies for therapy services and a proposal to study alternatives to the current reimbursement system.
To access the LeadingAge SNF PPS rate calculation tool, you may click here or go to the LeadingAge national website and look under the Members tab for Nursing Homes and then Payment and Finance.
This spreadsheet reflects the phase in of the change in definition of Metro areas to the new Office of Management and Budget guidelines. As a result, some providers may have changed from rural to urban or vice versa. The spreadsheet includes an extra feature to show the crosswalk from the old to the new Core Based Statistical Area (CBSA) designations.
Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827