Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities, etc.(CMS-1351-P)

Document ID: CMS-2011-0060-0002
Document Type: Proposed Rule
Agency: Centers For Medicare & Medicaid Services
Topics: Health Facilities, Kidney Diseases, Medicare, Reporting and Recordkeeping Requirements
Federal Register Number: 2011-10555
CFR Citation: 42 CFR Parts 413, 424, and 455
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Details Information

Abstract:	This proposed rule presents two options for updating the payment rates used under the prospective payment system for skilled nursing facilities (SNFs), for fiscal year 2012. In this context, it examines recent changes in provider behavior relating to the implementation of the Resource Utilization Groups, version 4 (RUG–IV) case-mix classification system and considers a possible recalibration of the case-mix indexes so that they more accurately reflect parity in expenditures between RUG–IV and the previous casemix classification system. It also includes a discussion of a Non-Therapy Ancillary component and outlier research currently under development within CMS. In addition, this proposed rule discusses the impact of certain provisions of the Affordable Care Act. It proposes to require for fiscal year 2012 and subsequent fiscal years that the SNF market basket percentage change be reduced by the multi-factor productivity adjustment. It also proposes to require Medicare SNFs and Medicaid nursing facilities to disclose certain information to the Secretary of the United States Department of Health and Human Services (the Secretary) and other entities regarding the ownership and organizational structure of their facilities. Finally, it proposes certain changes relating to the payment of group therapy services and proposes new resident assessment policies.
Document Subtype:	Published Proposed Rule
Received Date:	May 06 2011, at 12:00 AM Eastern Daylight Time
Start-End Page:	26364 - 26429
Page Count:	66
Comment Start Date:	May 6 2011, at 12:00 AM Eastern Standard Time
Comment Due Date:	June 27 2011, at 11:59 PM Eastern Standard Time