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CMS Announces Effective 1% Rate Increase and Contemplated Future Changes

On April 27, the Centers for Medicare & Medicaid Services (CMS) released their annual skilled nursing facilities (SNF) prospective payment system (PPS) for fiscal year 2018 and an Advance Notice of Proposed Rulemaking (ANPRM).

Providers can expect a 1% rate increase in Medicare Part A rates starting in October of 2017

The payment update in the SNF PPS announced the RUG rate changes based on CMS’s formulas to determine the market basket update. The rate increase, based on the formula, was defined as an increase of 2.3%. However, the increase will be capped at 1% for 2018 due to the market basket increase required by section 411(a) of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Big changes could be on the horizon

Additionally, according to Aegis’ team of clinical and legislative experts, CMS did something unusual by releasing an Advance Notice of Proposed Rule Making for next year – meaning we will likely see a proposed rule next year at this time which would become effective for FY2019, beginning on October 1, 2018. This gives providers about a year and a half to both comment on, and prepare, for proposed changes. This is more lead time then we normally see, but that might have something to do with the changes. “The notice of proposal contains some significant changes to how providers get reimbursed for Part A services,” said Barb Christensen, Clinical Services Director for Aegis Therapies. “The changes are big enough that it makes sense to give providers and software companies additional time to prepare.”

Preparing for change, big and small

Both documents released by CMS will require a close reading to better understand their full impact. Aegis’ clinical team is in the process of combing through each to fully understand them and begin developing any necessary updates to policies and procedures to ensure full compliance. Aegis will also be submitting feedback to CMS during the public comment period and will continue to update support materials for customers, including a comprehensive update to the popular Value Based Purchasing Program Playbook.

“This is a peek under the tent regarding changes on the horizon for us and our customers,” said Mark Besch, Vice President of Clinical Operations. “Based on these releases from CMS, it is unlikely that we will see sweeping reimbursement changes this year, and we will be reading these documents closely to ensure we are providing CMS with comprehensive feedback and developing internal policies and best practices that continue to best support our customers and patients.”

For more information

The proposed rule and ANPRM displayed on April 27, 2017, at the Federal Register’s Public Inspection Desk and will be available under “Special Filings,” at http://www.federalregister.gov/inspection.aspx. Public comments on the proposed rule and ANPRM will be accepted until June 26, 2017.

To learn more about Aegis Therapies services and support please contact (877) 877-9889 or customerservice@aegistherapies.com.

 

 

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