CMS Issues SNF PPS Proposed Rule
Despite staff and resources at the Centers for Medicare and Medicaid Services (CMS) being focused on Coronavirus issues, the Agency is preparing to publish the Federal Fiscal Year (FFY) 2021 Proposed Medicare Payment and Policy Changes for Skilled Nursing Facilities (SNFs) (CMS-1737-P) on April 15th. The rule calls for a 2.3 percent market basket increase, which would boost aggregate SNF payments by $784 million in FFY 2021 relative to FFY 2020. The rule does not seem to propose major changes to the Patient-Driven Payment Model (PDPM).
In response to stakeholder recommendations, the proposed rule includes several changes to the ICD-10 code mappings that would be effective beginning in FFY 2021. The rule also proposes Value-Based Purchasing (VBP) performance periods and performance standards for upcoming program years and would apply the 30-day Phase One Review and Correction deadline to the baseline period quality measure quarterly report. CMS is not proposing to make any changes to the measures, SNF VBP scoring policies, or payment policies.
Finally, the proposal contemplates changes to geographic delineations that would impact wage index region assignments for certain counties but would also apply a cap to ensure that no impacted region would experience a wage index decrease of more than 5 percent as a result of the change. The three counties potentially impacted in New York State are Dutchess, Orange, and Putnam.
The fact sheet is available here, and the published proposed rule will be here. We will provide a more complete analysis in the coming weeks. CMS will be accepting comments on the proposal until June 9th.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841