CMS releases proposed Skilled Nursing Facility FY 2019 PPS Update

CMS has issued a proposed rule that would update the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year 2019. This proposed rule also proposes to replace the existing case-mix classification methodology, the Resource Utilization Groups, Version IV (RUG-IV) model, with a revised case-mix methodology to be called the Patient-Driven Payment Model effective Oct. 1, 2019. The proposed rule also would update the Skilled Nursing Facility Quality Reporting Program and Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP). CMS notes that the aggregate impact of the payment update provisions of the proposal would be an increase of approximately $850 million in payments to SNFs in FY 2019. However, the overall economic impact of the SNF VBP Program is an estimated reduction of $211 million in aggregate payments to SNFs during FY 2019. For more information, see the fourth Financial Feature.

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