2019 Proposed Rules Skilled Nursing

An Analysis and Commentary on Federal Health Care Issues by Larry Goldberg

CMS Releases Proposed Skilled Nursing Facility FY 2019 PPS Update

The Centers for Medicare and Medicaid Services (CMS) have 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 (FY) 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 (PDPM) effective October 1, 2019. The proposed rule also would update the Skilled Nursing Facility Quality Reporting Program (SNF QRP) and Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP).

The document is currently on display at the Federal Register office. Publication is scheduled for May 8th. A copy of the 266-page document is at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-09015.pdf. This link will be superseded upon publication. The proposal provides a 60-day comment period ending June 26th.

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