CMS Issues Payment Rates, Policy Rules for Skilled Nursing, Rehab, Hospice
CMS Issues Payment Rates, Policy Rules for Skilled Nursing, Rehab, Hospice
Comment is being accepted through June 20
By Susan Morse
Dallas, TX | Posted April 22, 2016
The Centers for Medicare and Medicaid Services on Thursday released payment and policy changes for skilled nursing facilities, inpatient rehabilitation and hospice stays.
CMS projects payments to skilled nursing facilities will increase by $800 million in 2017 compared to 2016, or by 2.1 percent. This estimated increase is attributable to a 2.6 percent “market basket” increase, reduced by 0.5 percentage points, according to the adjustment required by law.
CMS is proposing to update the inpatient rehabilitation facilities payments to reflect an estimated 1.45 percent increase. This reflects a market basket estimate of 2.7 percent, reduced by a 0.5 percentage point productivity adjustment and a 0.75 percent reduction required by law.
CMS is finalizing a three-year phase out of the 14.9 percent rural adjustment for 19 inpatient rehabilitation facilities that changed status from rural to urban, due to the adoption of the newest Office of Management and Budget delineations.
The second year of the three-year phase-out is in 2017. The 19 providers will receive one-third of the 14.9 percent rural adjustment, CMS said.
For hospice, the cap amount for 2017 will be $28,377.17, which is equal to the 2016 cap amount $27,820.75 updated by a 2 percent.
The hospice payment is updated using the consumer price index for urban consumers.
CMS encourages comments on the proposed rules by June 20.
In addition to payments, CMS is proposing new assessment-based quality measures, and claims-based measures for inclusion in the quality reporting program.
CMS will assess hospice staff visits to patients and caregivers in the last week of life. In a second measure, CMS will assess the percentage of hospice patients who received care.
For skilled nursing facilities, CMS is using measures assess the rate at which patients are readmitted to a hospital within 30 days of being discharged as a hospital inpatient.
Beginning in 2018, skilled nursing facilities are required to take part in a quality reporting program. Those that do no do not submit data will be subject to a 2 percent reduction to their annual updates, CMS said.