Nursing Home Payment and Finance
We advocate for Medicare and Medicaid payment systems for nursing homes that will appropriately account for essential costs of high quality care. We work with the Centers for Medicare and Medicaid Services (CMS) to obtain the most up-to-date information on payment policies and updates.
The Centers for Medicare & Medicaid Services recently finalized their physician fee schedule final rule for 2015. The rule includes updates to overall payment of physician services, including therapy services. LeadingAge’s Part B Therapy Rate Calculation Tool has been revised to reflect changes made in the final rule. This tool automatically calculates your facilities Medicare Reimbursement for CY 2015 rates, effective January 1, 2015.
The American Medical Association (AMA) recommendation to include 2 newly created advance care planning codes in the physician fee schedule final rule was rejected by the Centers for Medicare and Medicaid Services.
On Oct. 29, the Medicaid and CHIP Payment and Access Commission (MACPAC) released data on Medicaid nursing facility payment policies in each of the 50 states and Washington, DC. Since state Medicaid payment policies vary greatly across states, this tool may be helpful to members as they advocate to their state officials on Medicaid skilled nursing facility payment policy.
At a recent meeting, the Medicare Payment Advisory Commission (MedPAC) discussed proposals to allow hospitals to recommend post-acute care providers to Medicare beneficiaries on discharge. Current law does not permit this kind of recommendation. The commission did not reach a conclusion on any changes in current policy. However, this discussion shows why it is important for nursing homes and other post-acute care providers to focus on quality measure performance and the development of relationships with hospitals and physician organizations.
On July 11, the Centers for Medicare and Medicaid Services (CMS) released the physician fee schedule proposed rule, which includes provisions relating to implementation of separate payment for chronic care management (CCM) services.