On April 5, 2019, the Centers for Medicare and Medicaid Services (CMS) issued the final rule for Medicare Advantage (MA) program (Part C) regulations and Prescription Drug Benefit program (Part D) regulations for calendar year 2020. In this final rule, CMS is implementing several sections of the Bipartisan Budget Act of 2018. One of the sections CMS is implementing is Section 50323 that will allow MA plans to offer “additional telehealth benefits” as part of the government-funded “basic benefits”. Will these “additional telehealth benefits” include physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs)? Continue reading to find out.
Archives for April 22, 2019
The Centers for Medicare and Medicaid Services (CMS) has released the Skilled Nursing Facility (SNF) fiscal year (FY) 2020 proposed rule. CMS has published a fact sheet that highlights 3 major provisions of the proposed rule that are:
- The proposed changes to SNF payment policy under the SNF Prospective Payment System (PPS)
- The SNF Value-Based Purchasing Program (VBP)
- The SNF Quality Reporting Program (QRP)
In FY 2020, CMS expects payments to SNF’s to increase by 2.5% compared to FY 2019. CMS is proposing to change the definition of group therapy in the SNF Part A setting to align with the inpatient rehabilitation definition of group which is: “group therapy consists of two to six patients doing the same or similar activities”.
CMS will accept comments on the proposed rule until June 18, 2019. To access the fact sheet and the proposed rule, click HERE. The proposed rule is scheduled to be published in the Federal Register on April 25, 2019.
In addition, Gawenda Seminars & Consulting, Inc. will be providing a webinar on June 4, 2019 from 1:00pm – 2:30pm EDT on the SNF Patient Driven Payment Model (PDPM) that will begin on October 1, 2019. This new payment model will fundamentally change the drivers of SNF payments and represents another step towards the CMS vision for value-based purchasing. CMS has openly discussed how the proposed PDPM will provide patients an opportunity “to choose a skilled nursing facility that offers services tailored to their condition and preferences”.
For additional information on this webinar and to register, click HERE.