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PDPM Comments Due June 26th

LeadingAge NY reminds members that they have until June 26th to submit comments on the Skilled Nursing Facility Prospective Payment System (SNF PPS) Rule that includes the proposal to implement a new case-mix classification system as the basis for SNF Medicare Part A payments effective Oct. 1, 2019. The Patient-Driven Payment Model (PDPM) would base payment not on the amount of services provided but on resident characteristics that are predictive of service needs. While a focus on more accurately reimbursing for the cost of care, especially for nursing services, as well as impact estimates provided by the Centers for Medicare and Medicaid Services (CMS) suggest that many not-for-profit providers would see a potential increase in revenue under the change, we urge members to review the pieces of the proposal for areas that may raise concerns.

Our memo outlining the proposed methodology is available here, and some key questions that may prompt comments are here.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841