Feds Call for New SNF Payment System A new proposal from the Centers for Medicare and Medicaid Services (CMS) seeks to overhaul Medicare payments for skilled nursing facility (SNF) patients, a change that would significantly affect speech-language pathologists who work in SNFs. In an Advanced Notice of Proposed Rulemaking, CMS proposes to restructure the current SNF prospective ... News in Brief
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News in Brief  |   November 01, 2017
Feds Call for New SNF Payment System
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Special Populations / Older Adults & Aging / Healthcare Settings / News in Brief
News in Brief   |   November 01, 2017
Feds Call for New SNF Payment System
The ASHA Leader, November 2017, Vol. 22, 11. doi:10.1044/leader.NIB2.22112017.11
The ASHA Leader, November 2017, Vol. 22, 11. doi:10.1044/leader.NIB2.22112017.11
A new proposal from the Centers for Medicare and Medicaid Services (CMS) seeks to overhaul Medicare payments for skilled nursing facility (SNF) patients, a change that would significantly affect speech-language pathologists who work in SNFs.
In an Advanced Notice of Proposed Rulemaking, CMS proposes to restructure the current SNF prospective payment system (PPS) in coming years. The proposal marks a shift away from the PPS—which sets per-patient reimbursement based on the amount of services and rehabilitation therapy the SNF provides to the patient—and toward payment related to the patient’s condition, medical complexity, expected needs and outcomes.
The proposal would eliminate the current system of Resource Utilization Groups, Version 4 (RUG-IV) and replace it with a Resident Classification System, Version I (RCS-I), based on categories of patient condition, complexity and co-morbidities. RCS-I would create four distinct case-mix components for SNF reimbursement focused on expected need for services.
Under the proposal, speech-language pathology services constitute one category of services. Other categories are combined physical therapy and occupational therapy, nursing, and non-therapy ancillary. The categories were established based on data correlating specific conditions to the need for services within the distinct case-mix components.
CMS did not establish an implementation date for RCS-I, but indicated a potential proposed rule for as early as 2019.
The RCS-I proposal is similar to a recently released proposed rule for home health payment. The Home Health Grouping Models (HHGM)—based on patient condition and complexity—are designed to replace the current Home Health Prospective Payment System (HH-PPS). The HHGM is scheduled for 2019 implementation.
ASHA responded to the CMS call for public comments on the proposed SNF payment system changes and will continue to advocate in the interest of ASHA members and SNF patients. Look for more details as CMS works to refine and finalize a new system over the next couple of years.
To receive updates on CMS reimbursement policies and other policy and advocacy developments critical to audiology and speech-language pathology services, sign up for ASHA Headlines.
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FROM THIS ISSUE
November 2017
Volume 22, Issue 11