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SNF Medicare Payment Rule to Increase Part A Rates by 4 Percent

The Centers for Medicare and Medicaid Services (CMS) has finalized the rule that sets Medicare Part A reimbursement rates for nursing homes. The Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule will increase payments by 4 percent starting Oct. 1st, higher than the 3.7 percent increase in the proposed rule. Behind the 4 percent net increase is a 3 percent inflation adjustment, a forecast error adjustment of +3.6 percent to correct for a prior year’s underestimate of inflation, a productivity adjustment of negative 0.2 percent, and a 2.3 percent decrease to the Federal Fiscal Year (FFY) 2024 SNF PPS rates as a result of the second year of the Patient-Driven Payment Model (PDPM) parity adjustment recalibration. The recalibration is meant to adjust for payment increases that CMS believes resulted solely from the change in reimbursement methodology from Resource Utilization Group (RUG)-IV to PDPM. In sum, the changes are expected to increase payments by approximately $1.4 billion nationwide in FFY 2024.

Along with the reimbursement updates, CMS is finalizing most of the provisions of the proposed rule related to the SNF Quality Reporting Program (QRP) as well as the continued gradual increase in the number of measures on which the Value-Based Purchasing (VBP) program is based. Notably, CMS decided not to adopt the CoreQ Short Stay Discharge measure that would have required homes to contract with vendors to submit satisfaction survey data to CMS.

A fact sheet is available here, and the pre-publication version of the final rule is available here. A full summary of the provisions as well as wage index tables and rate calculator will be distributed shortly.

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