The Centers for Medicare & Medicaid Services (CMS) late Thursday issued a final rule updating Medicare payment policies — namely a delay to Patient-Driven Payment Model (PDPM) pay rate changes until next year and adjustment of provider pay by 1.2%.
This was a decrease for fiscal 2022 compared to the agency’s proposed 1.3% boost in April. Still, the aggregate impact of these payment policies to the SNF Prospective Payment System (PPS) is an approximate increase of $411 million in Medicare Part A payments to facilities next year.
This figure doesn’t incorporate $184.25 million in SNF value-based purchasing program (VBP) reductions, CMS said.
The PDPM delay is a welcome respite for providers in the skilled space, as many anticipated adjustments when CMS in April disclosed a whopping 5% increase in spending under the program in 2020 — about $1.7 billion more than the previous Resource Utilization Group (RUG) system. PDPM was designed to be budget neutral.
Quality reporting measures were changed with the final rule as well; SNFs in 2023 will need to report health care-associated infections (HAIs) like pneumonia, urinary tract infections and sepsis to CMS.
“We would like to thank CMS Administrator Chiquita Brooks-LaSure for this increase and for delaying any potential parity adjustment actions until Fiscal Year 2023,” Mark Parkinson, president and CEO of the American Health Care Association (AHCA) said in a statement regarding CMS final rule updates.
Added Parkinson: “The ongoing costs to fight the pandemic have left the majority of nursing homes struggling to stay afloat. Long term care providers need sustained support to keep residents and staff safe, and it is vital that Medicare remain a reliable funding source and reflect the increasing costs providers are facing.”
