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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.

 

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MACPAC Releases Breakdown of State Medicaid Nursing Facility Payment Policies

On October 29th, 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.

MedPAC Considers Allowing Hospitals to Recommend Post-Acute Care Providers

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.

Changes to Chronic Care Management Codes Proposed by CMS

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.

SNF Payment Rate Updated for FY 2015

A minor update was made to our Rate Calculator for the skilled nursing facility (SNF) prospective payment system (PPS) for fiscal year (FY) 2015. It now includes the co-pays for 2014 and 2015. In addition, a footnote was added on the temporary add-on payment of 128% in the PPS per-diem payment for any skilled nursing facility with residents who have Acquired Immune Deficiency Syndrome (AIDS). This add-on has been effective since 2004. If you have any questions, please contact Heather Boyd at hboyd@leadingage.org.  

ICD-10 Compliance Date Delayed Until 2015

Oct. 1, 2015, is the new ICD-10 compliance date for providers, according to a final rule issued July 31 by the U.S. Department of Health and Human Services (HHS).