Today, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2024 update.
Highlights include:
- The proposed rule provides for a net market basket increase for SNFs of 3.7 percent (approximately $1.2 billion) beginning October 1, 2023. This is the second year the statutory forecast error provision had a profound impact on the net market basket. Under the forecast error statutory provision, CMS compares a projected market basket update with the actual market basket update using prior year data. Intended to account for inflation, the forecast increases the market basket when the projected market basket is 0.5% less than the actual market basket. Conversely, when the forecast decreases the market basket when the projected market basket is 0.5% more than the actual market basket. If the variance in either direction is less than 0.5%, no forecast error is incurred. This year, the difference between forecasted and actual, 3.6%, was applied to our unadjusted market basket of 2.7% resulting in 6.3%. This more than offset the impacts of the second, and final, year of the parity adjustment, a 2.3% reduction, as well as the productivity adjustment, a 0.2% decrease.
- The proposed rule did not include minimum staffing requirements. The CMS fact sheet released with the proposed rule states, “CMS continues to review the feedback and evidence from both the comment solicitation and mixed-methods study, all of which will be used to inform proposals for minimum direct care staffing requirements in nursing homes in rulemaking this Spring.” AHCA will continue to focus on this important issue and keep members updated as more information becomes available.
- Proposed changes to § 488.436(a) Civil Money Penalties (CMP) would allow facilities to receive by default the 35 percent penalty reduction when the facility has not appealed within the 60-day timeframe. If finalized, this would reduce paperwork processing for facilities, CMS and States as facilities would no longer need to submit a written waiver of a hearing to appeal deficiencies that lead to the imposition of a CMP.
AHCA is currently reviewing the proposed rule in greater detail and will share a more detailed summary Wednesday, including proposed changes to the SNF Quality Reporting Program and Value-Based Purchasing program.
AHCA will also host a member webinar on Friday, April 7 at 2 PM Eastern. More information, including the registration link, will be provided soon. The webinar will be recorded for those unable to participate in person.
Thank you for your continued support. Please contact
Mike Cheek with any questions.