CMS Proposes 2009 Skilled Nursing Facility Prospective Payment Rule

On May 1, 2008, the Centers for Medicare & Medicaid Services (CMS) issued a Press Release announcing the release of a display copy of a Proposed Rule that would update the skilled nursing facility (SNF) prospective payment system for fiscal year (FY) 2009.

According to the Press Release, the Proposed Rule would recalibrate the case mix weights to reestablish budget neutrality on a prospective basis and recalibrate refinements that accounted for the use of non-therapy ancillary services. For FY 2009, CMS projects that the impact of the proposed recalibration would be a negative $770 million.  However, CMS expects for the negative $770 million to be offset by a FY 2009 market basket adjustment factor of 3.1 percent (or $710 million).  Therefore, the Proposed Rule would result in a negative annual update for SNFs of approximately $60 million in FY 2009.

In the Proposed Rule, CMS also addresses its ongoing analysis of nursing home staff time measurement data collected in the Staff Time and Resource Intensity Verification (Strive) project.  CMS also proposes technical corrections in the regulatory text with respect to Medicare bad debt payments to SNFs. 

The Proposed Rule is scheduled to appear in the Federal Register on May 7, 2008. CMS is expected to accept comments on the Proposed Rule until June 30, 2008.  The Proposed Rule explains how to submit comments to CMS.