Skilled Nursing Reimbursements To Rise $750 Million in 2015

The 2015 skilled nursing facility prospective payment system (SNF PPS) will receive a boost in Medicare reimbursement, to the tune of an estimated $750 million in aggregate payments, according to The Centers for Medicare & Medicaid Services’ (CMS) final rule on Medicare payments for skilled nursing.

The 2% Medicare rate increase in reimbursements represents a higher payment update factor than the 1.3% update that was finalized for skilled nursing reimbursements last year. The estimated increase is attributable to 2.4% market basket increase, reduced by the four basis point multifactor productivity adjustment required by law.

“The 2% market basket increase to providers’ Medicare reimbursement included in this rule is welcome news for skilled nursing providers,” says American Health Care Association’s (AHCA) President & CEO Mark Parkinson in a news release. “Multiple government reductions in recent years have strained long term and post-acute care providers. A stable, reliable Medicare payment system is one important element in keeping skilled nursing care accessible to our seniors.”

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In addition, the new rule adopts the most recent Office of Management and Budget (OMB) statistical area delineations to identify a facility’s urban or rural status for the purpose of determining which set of rate tables will apply to the facility, and to determine the SNF PPS wage index including a 1-year transition with a blended wage index for all providers for fiscal year 2015.

This rule also contains a revision to policies related to the Change of Therapy (COT) Other Medicare Required Assessment (OMRA,), which would permit providers, in certain circumstances to complete a COT OMRA for a resident who is not currently classified into a RUG-IV therapy group, or receiving a level of therapy sufficient for classification into a RUG-IV therapy group.

Beginning next year, tables setting forth the Wage Index for Urban Areas Based on CBSA Labor Market Areas and the Wage Index Based on CBSA Labor Market Areas for Rural Areas will no longer published in the Federal Register. Instead, these tables will be available exclusively through the CMS website.

“AHCA will continue working together with CMS and the administration to ensure Medicare remains a strong program for its beneficiaries requiring skilled nursing services,” Parkinson says.

Read the final rule here.

Written by Cassandra Dowell

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