CMS Releases Proposed FFY 2014 SNF PPS Rule

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CMS has released its proposed federal fiscal year (FFY) 2014 prospective payment system (PPS) rule for Medicare Skilled Nursing Facilities (SNFs). The rule projects a net increase in operating payments to SNFs in the amount of $500 million for FFY 2014, a 1.4% increase in comparison with FFY 2014 payments. The proposed rule can be viewed here [PDF]. Comments on the proposed rule are due by July 1, 2013.

Among other changes, the proposed rule would:

  • Apply a 2.3% market basket increase. The increase would be reduced by 0.5% to account for the error in the projected market basket increase for FFY 2012, and further reduced by 0.4% to account for the multifactor productivity adjustment established by Section 3401(b) of the Affordable Care Act. Therefore, the total net increase in operating payments to SNFs is expected to be 1.4% for FFY 2014.
  • Revise and rebase the market basket, using data from FFY 2010, and add five cost categories. The five new cost categories would be: (1) Medical Instruments and Supplies; (2) Apparel; (3) Machinery and Equipment; (4) Administrative and Facilities Support Service; and (5) Financial Services.
  • Modify the reporting of therapy services. The rule would add an item to the Minimum Data Set to record the number of distinct calendar days of therapy provided to a patient over the seven day look-back period. Since calendar day data is not currently captured, SNFs may currently be reporting multiple “days” of therapy services that are provided to SNF residents on the same calendar day. Based on the newly captured information, the qualifying conditions for the Medium Rehab and Low Rehab categories would be “clarified” to require the provision of services on distinct calendar days.

Topics:  CMS, Medicare, Provider Payments, Reporting Requirements, SNF

Published In: Health Updates, Insurance Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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