Dive Brief:
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CMS announced a proposed rule on Monday that skilled-nursing facilities (SNFs) will receive a $370 million increase in federal payments in 2018, which is less than the $920 million increase SNFs got this year.
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In a separate rule, CMS said inpatient rehabilitation facilities would increase by about 0.9% ($75 million) in 2018.
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That rule also removed claims data requirements for rehab facilities, including a 25% payment penalty for not submitting Medicare Part A claims in a timely manner, and proposed changing the rule that 60% of inpatient rehab patients have certain medical conditions in order for the facility to quality for federal reimbursement.
Dive Insight:
CMS’ SNF final rule issued on Monday is part of CMS’ shift from fee-for-service payments to a value-based purchasing (VBP) program. The changes to a value-based system will result in a 1% increase over payments in the current fiscal year.
CMS has created scoring and operational policies for the SNF VBP program's first year in FY 19. The program, which kicks off on Oct. 1, 2018, will take into account a facility’s care metrics, including readmission rates, when deciding on payment.
CMS hopes to transfer 50% of its traditional FFS Medicare payments to alternative payment models by 2018.
Meanwhile, the final rule focusing on rehab includes an increase factor that’s part of MACRA. After receiving stakeholder comment, the CMS also said that it would not finalize the proposed removal of certain ICD-10-CM codes from the presumptive methodology. The CMS said it continues to monitor and will consider “their appropriateness for inclusion on the presumptive methodology lists for future development and rulemaking.”