CMS Proposes Changes to Medicare SNF PPS and Quality Measures

The Centers for Medicare & Medicaid Services (CMS) recently unveiled a proposed rule for the Skilled Nursing Facility Prospective Payment System (SNF PPS), suggesting a 2.4% adjustment in Medicare reimbursement rates. This proposed adjustment results from a 3.2% market basket update counterbalanced by a 0.8% productivity reduction. Crucially, this projection does not account for potential reductions originating from the SNF Value-Based Purchasing (VBP) program, anticipated to culminate in a $208.4 million net decrease in payments by 2026.

CMS is also intending to remove two measures from the Skilled Nursing Facility Quality Reporting Program (SNF QRP) starting in 2028, including Covid-19 vaccination coverage among healthcare staff and patients. Feedback is sought on a new potential measure concerning advanced care planning. Proposals also aim to expedite data reporting, with a new schedule mandating data submission by the 15th day of the second month after the calendar quarter, starting in the 2029 program year.

Additionally, CMS proposes that all residents receiving skilled care be incorporated into the Minimum Data Set (MDS) reporting, regardless of payment source. This initiative seeks to enhance the accuracy and comprehensiveness of facility data. For comprehensive industry insights, contact Amy at [email protected] or 312-967-0762.