News Digest: 2023 Proposed Rule from CMS
Fiscal Year (FY) 2023 Skilled Nursing Facility Prospective Payment System Proposed Rule (CMS 1765-P)
On April 11, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY) 2023. In addition, the proposed rule includes proposals for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Program (VBP) for FY 2023 and future years. CMS is publishing this proposed rule consistent with the legal requirements to update Medicare payment policies for nursing homes on an annual basis. This fact sheet discusses the major provisions of the proposed rule.
Fiscal Year (FY) 2023 Skilled Nursing Facility Prospective Payment System Proposed Rule (CMS 1765-P) | CMS. www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2023-skilled-nursing-facility-prospective-payment-system-proposed-rule-cms-1765-p.
CMS Releases Skilled Nursing Facility PPS Proposed Rule for FY23
CMS has released its proposed Skilled Nursing Facility (SNF) Prospective Payment System (PPS) rule for fiscal year 2023, which includes a reduction in Medicare payments for SNFs. The proposed payment policies decrease Medicare Part A payments to SNFs by around $320 million in FY 2023, CMS estimated.
The Total Nursing Hours per Resident Day measure would also take effect in FY 2026, which uses auditable electronic data to calculate total nursing hours per resident day.
CMS is also seeking feedback on including a Nursing Home Staff Turnover measure in the VBP program. The measure uses data from the CMS payroll-based journal system and reports annual turnover for nurses.
Baily, Victoria. “CMS Releases Skilled Nursing Facility PPS Proposed Rule for FY23.” Revcycle Intelligence, 13 Apr. 2022, revcycleintelligence.com/news/cms-releases-skilled-nursing-facility-pps-proposed-rule-for-fy23.
Nursing home pay rule reveals CMS strategy on minimum staffing
The release of a proposed 2023 pay rule Monday afternoon reiterated the Centers for Medicare & Medicaid Services’ commitment to implementing a minimum staffing rule after more than 20 years of debate on the issue. Staffing-related provisions include a new value-based incentive element for total nurse staffing and an official request for comment on the coming direct care staffing requirements.
CMS, however, has much to consider in a yearlong study leading up to an officials staffing rule set to be proposed early next spring.
The agency Monday asked stakeholders to weigh in on at least 17 related issues.
Marselas, Kimberly. “Nursing Home Pay Rule Reveals CMS Strategy on Minimum Staffing.” McKnight’s Long-Term Care News, 13 Apr. 2022, www.mcknights.com/news/nursing-home-pay-rule-reveals-cms-strategy-on-minimum-staffing.
‘Embrace’ staffing measures in new CMS pay rule, expert advises
While proposed funding cuts grabbed the spotlight in the administration’s newly offered nursing home pay rule Monday, also within it are some highly noteworthy plans regarding President Joe Biden’s minimum staffing initiative.
CMS said it’s specifically seeking input on establishing minimum staffing requirements that nursing homes “will need to meet to ensure all residents are provided safe, high-quality care, and nursing home workers have the support they need.” The administration said on Feb. 28 that it would research and propose federal minimum staffing levels within a year — a goal that Health and Human Services Secretary Xavier Becerra has since said he expects to beat.
On Monday, CMS also said it is asking for stakeholder comment on the implementation of a nursing home staff turnover measure in the SNF value-based purchasing program.
Brown, Danielle. “‘Embrace’ Staffing Measures in New CMS Pay Rule, Expert Advises.” McKnight’s Long-Term Care News, 12 Apr. 2022, www.mcknights.com/news/embrace-staffing-measures-in-new-cms-pay-rule-expert-advises.
