Proposed Rule Season

Nelson Mullins Riley & Scarborough LLP

The Centers for Medicare & Medicaid Services (CMS) have released the proposed updates to the Medicare payment policies and rates for skilled nursing facilities (SNFs) for 2024. While the ruling is not final, “CMS estimates that the aggregate impact of the payment policies in this proposed rule would result in a net increase of 3.7% or approximately $1.2 billion.”

These major payment rules reflect the Biden Administration's continued efforts to promote health equity and genuine marketing to the public. However, speculation exists as to the effectiveness of this increase as “[l]ayering these inadequate inflationary adjustments on top of Medicare’s existing underpayments to hospitals does not reflect the reality of the world hospitals are providing care in.”

CMS noted that it continues to review comments related to minimum staffing requirements. It also proposed changes to the ICD-10 code mapping for the Patient-Driven Payment Model, which classifies patients in a covered Part A stay, proposed changes, including the adoption of three new measures, for the Quality Reporting Program, and proposed changes, including the adoption of four new measures, for the Value Based Purchasing Program in an effort to advance health equity.

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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