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CMS Increases Payment Rates for Skilled Nursing Facilities, Inpatient Rehab, and Hospice

May 16th, 2017

The Centers for Medicare & Medicaid Services recently issued new proposed rules regarding payment and policy for skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), and hospice providers.

The proposed new rule for SNFs updates the payment rates used under the prospective payment system (PPS) that was adopted last year. The rule also outlines significant changes to the SNF Quality Reporting Program (SNF QRP) and the SNF Value-Based Purchasing Program (SNF VPP), as well as changes to regulatory requirements for investigating a complaint against the SNF.

CMS also has published an Advance Notice of Proposed Rulemaking (ANPRM) on options for revising the SNF PPS to improve its accuracy. The ANPRM seeks public comment on replacing the current classification model known as the Resource Utilization Groups with a new model, known as Resident Classification System.

The proposed rule for IRFs updates how the prospective payment rates for 2018 are calculated. There also is a proposal to remove the 25% payment penalty for IRF patient assessment instrument (PAI) late transmissions and other changes to the IRF PAI payment criteria, and to update the IRF quality reporting program.

The proposed updates for hospice providers include changes to the hospice wage index, payment rates, and cap amount for 2018. The rule also proposes changes to the hospice quality reporting program and other quality collection data.

In accordance with the Medicare Access and CHIP Reauthorization Act of 2015, IRF, SNF, and hospice payments will increase by 1% relative to 2017.

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