CMS Releases FY 2015 SNF Final Rule

August 6, 2014
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Rick Gawenda
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On August 5, 2014, the Centers for Medicare and Medicaid Services (CMS) issued Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2015; Final Rule. Payments to skilled nursing facilities (SNFs) will increase by 2% in FY 2015. This translates to an estimated additional $750 million compared to FY 2014.

SNF Therapy Research Project

CMS contracted with Acumen, LLC and the Brookings Institution to identify potential alternatives to the existing methodology used to pay for therapy services received under the SNF PPS. Under the current payment model, the therapy payment rate component of the SNF PPS is based solely on the amount of therapy provided to a patient during the 7-day look-back period, regardless of the specific patient characteristics. The amount of therapy a patient receives is used to classify the resident into a RUG category, which then determines the per diem payment for that resident.

In their response, CMS states it appreciates the broad support for this research initiative, understands the importance of completing this work in both a timely and efficient manner and recognizes the importance of seeking input stakeholders on how best to revise current therapy payment model. CMS states it is premature at this time to speculate on when a new payment model will be ready to be implemented.

Comments on this topic may still be provided outside the rulemaking process, and these comments should be sent via email to SNFTherapyPayments@cms.hhs.gov. Information regarding this project can be found on the project Web site at
http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/therapyresearch.html.

Revisions to Change of Therapy (COT) Other Medicare Required Assessment (OMRA)

CMS finalizes their proposal to permit providers, in certain circumstances (discussed below), to complete a COT OMRA

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