Payment provisions outlined for implementation of Bipartisan Budget Act of 2018

The Bipartisan Budget Act of 2018, signed into law on Feb. 9, addresses policy issues that took effect on Jan. 1 and includes several Medicare payment provisions to extend key funding programs that expired in October 2017. The Centers for Medicare & Medicaid Services (CMS) released information recently detailing implementation of these provisions.

Medicare Administrative Contractors (MAC) will implement these changes no later than Feb. 26, 2018, and will provide additional details on timelines for reprocessing or release of held claims impacted by these changes.

  • Section 50201: Extension of Work Geographic Practice Cost Index (GPCI) floor.
  • Section 50202: Permanent repeal of the payment cap on outpatient therapy.
  • Section 50203:  Extension of Medicare Ambulance Services.

For the following Medicare provisions, Medicare claims processing system changes are

under development but are anticipated to be included in systems changes effective in the spring. As system changes are implemented, CMS will share information related to any necessary claims reprocessing.

  • Section 50204: Extension and change to the expanded Low Volume Hospital (LVH) Adjustment through FFY 2022.
  • Section 50208: Extension and change to the Rural Home Health (HH) Add-on through CY 2022.
  • Section 51005: Extension of the blended site-neutral payment rate under the Long-Term Care Hospital (LTCH) PPS through FFY 2019.

CMS has received questions from stakeholders about the impact of the FY 2019 Skilled Nursing Facility update.

  • Section 53111: Setting the adjusted Skilled Nursing Facility (SNF) PPS market basket update for FFY 2019 to 2.4 percent.