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SNF Medicare Part A Rates Effective Oct. 1, 2015

The Centers for Medicare and Medicaid Services (CMS) have released the final rule for the skilled nursing facility (SNF) prospective payment system (PPS).   This release includes the payment provisions for Medicare Part A rates effective with the 2015 federal fiscal year (FY) starting Oct. 1, 2014.

Except for a slight change in the calculation of the net market basket increase (MBI), the final rule is consistent with the original notice of proposed rulemaking, and includes the following provisions:

  • A 2.5 percent MBI minus a 0.5 percent multifactor productivity adjustment for a net increase of 2.0 percent in SNF PPS rates (the proposed rule originally contained a 2.4 percent MBI minus 0.4 for the same net 2.0 percent increase);
  • 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.

The final rule is also consistent with our previous analysis of the proposed change in the delineation of core-based statistical areas (CBSA) to determine a provider's status as urban versus rural and implements a transitional wage index.  For a New York county-specific analysis of the CBSA change please click here.

LeadingAge has updated their spreadsheet that allows members to calculate the total impact of the proposed rule on Skilled Nursing Facility (SNF) Prospective Payment System (PPS) rates for FY 2015.  This calculation tool incorporates the transitional wage index.  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 also incorporates a factor for calculating the ongoing impact of sequestration, which continues to reduce overall Medicare payments by 2 percent. Please contact Patrick Cucinelli, if you have difficulty accessing this spreadsheet.

LeadingAge NY is in the process of compiling the New York-specific Medicare Part A rates for each of the Resource Utilization Groups (RUGs) broken down by specific regions of the State for our members, along with additional analysis of the programmatic issues contained in the rule as they apply to New York providers.

Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827