The CMS said it plans to trim $770 millionor about 3.3%in overall payments to skilled-nursing facilities in fiscal 2009, but would help the industry absorb those losses with a 3.1% inflationary update. As a result, nursing homes will absorb a net $60 million loss this year and next, according to a proposed rule released by the CMS.
Separately, the CMS also said it would expand Medicare coverage of artificial hearts when they are implanted as part of a Food and Drug Administration-approved study that meets certain Medicare research criteria.
Under the proposed SNF payment rule, the CMS said it would rework the case-mix weights as a way to better align payments with the right procedures. The agency also said that it may include certain pay-for-performance initiatives and other changes aimed at bettering patient care.
The payment changes by the CMS are part of a series of moves by the agency to correct what it sees as upcoding by the industry, according to a health policy analyst. The CMS continues to look at coding and make downward adjustments to offset increases in coding that are not related to severity, said Larry Goldberg, a consultant based in Oakton, Va.
We are confident that with the payment rates we are proposing today, the nations skilled-nursing facilities would be able to continue to provide high-quality services to those who need critical skilled-nursing facility care services, acting CMS Administrator Kerry Weems said in a written statement.
A public comment period will run until June 30. -- by Matthew DoBias
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