Nursing Homes Worried Proposed CMS Pay Model Would Strip Away Flexibility For Determining Patient Care
The facilities are also concerned that the new patient categories proposed in the rule won't actually improve pay accuracy.
New CMS Nursing Home Model Raises Pay Accuracy Concerns
Nursing homes are questioning if a proposed CMS pay model could pay them less for services provided to Medicare patients. On Friday, the CMS proposed the Patient-Driven Payment Model which would replace the resource utilization groups model they are paid under now.The CMS pays skilled-nursing facilities on a prospective fee schedule, which means they are a paid a predetermined amount for services they provide. The current skilled-nursing pay system separates patients into two broad care categories based on the level of care they require: patients who need general nursing services and patients who need physical, occupational and speech therapy. (Dickson, 5/2)
In other news —
HHS Takes DSH Reimbursement Fight To Supreme Court
HHS and providers have taken their fight over billions of dollars in Medicare payments to the U.S. Supreme Court, as the agency tries to protect its calculation of disproportionate-share hospital payments. In a petition filed last week, HHS maintained that it followed proper procedure in 2014 when it started factoring Medicare Advantage beneficiaries' inpatient stays into disproportionate-share hospital payments for fiscal 2012. The agency said it didn't need to hold a public comment period to allow hospitals to weigh in. (Luthi, 5/1)