The Centers for Medicare & Medicaid Services (CMS) has issued the federal fiscal year (FFY) 2021 proposed rule for the skilled-nursing facility (SNF) prospective payment system, which would update the Medicare payment rate and quality reporting programs. The provisions in the proposed rule, if finalized, would be effective Oct. 1, 2021.
SDAHO is currently reviewing the proposed rule and will provide a brief summary and impact in the coming weeks for members. Comments are due to CMS by 2 p.m. (PT) on June 9, available is the CMS Fact Sheet.
CMS proposes to increase net payments by 2.3% — or $784 million — compared to FFY 2020 as a result of a 2.7% market-basket update, offset by a 0.4 percentage point reduction for multifactor productivity adjustment.
CMS proposes to adopt revised geographic delineations provided by the Office of Management and Budget, which are used to identify a provider’s status as an urban or rural facility and to calculate the wage index, as well as to cap wage index decreases at 5% .
CMS continues to refine the patient driven payment model methodology and proposes changes to the ICD-10 code mappings that would be effective beginning in FFY 2021.
SNF Value-Based Purchasing (VBP) Program
CMS proposes to align the SNF VBP Program regulation text with previously finalized policies, to apply the 30-day Phase One Review and Correction deadline to the baseline period quality measure quarterly report, and to establish performance periods and performance standards for upcoming program years.
CMS does not propose to make any changes to the measures, SNF VBP scoring policies, or payment policies.