Skilled Nursing Facility Prospective Payment System Final Rule Released for Fiscal Year 2020

Posted on August 07, 2019

The Centers for Medicare & Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service prospective payment system for skilled nursing facilities (SNFs) for fiscal year (FY) 2020. Highlights of the final rule, which take effect Oct. 1 unless otherwise noted, include:

  • A net 2.3% marketbasket increase after the 2.8% marketbasket increase is reduced by the 0.4 percentage point productivity adjustment and budget neutrality. Facilities that fail to comply with reporting requirements for the FY 2020 SNF quality reporting program (QRP) would be subject to a 2 percentage point reduction to the marketbasket update.
  • Implementation of the new patient-driven payment model (PDPM), which adjusts Medicare payments based on each component of a resident’s care, most notably for Nontherapy Ancillary services such as drugs and medical supplies. The PDPM, finalized in the FY 2019 SNF final rule, should more accurately address the higher costs of medically complex patients and is expected to improve payments to hospital-based SNFs. 
  • The CMS did not finalize its proposal to require the reporting of patient assessment data for all SNF residents, regardless of their payer. 
  • Adoption of two new process measures for the FY 2022 SNF QRP; SNFs will be required to begin collecting data for both measures Oct. 1, 2020. 
    • The “Transfer of Health Information to the Provider — Post Acute Care” measure assesses whether a current reconciled medication list is given to the subsequent provider when a patient is discharged or transferred from a SNF to another facility. 
    • The “Transfer of Health Information to the Patient — Post Acute Care” assesses whether a current reconciled medication list is provided to the patient, family or caregiver when the patient is discharged from a SNF to a private home.

In the coming weeks, the MHA will provide additional information regarding the final rule, including updated facility-specific impact analyses. Members with questions should contact Vickie Kunz at the MHA.

Tags: Medicare, CMS, SNF, final rule, skilled nursing facilities

Posted in: Member News

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