Industry News

CMS Issues SNF PPS Final Rule for FY 2014.

Jennifer Kirchner | July 2013

The Centers for Medicare & Medicaid Services (CMS) recently issued a Prospective Payment System (PPS) final rule updating payment rates for skilled nursing facilities (SNFs) for fiscal year (FY) 2014.  CMS reported that the economic impact of this final rule is an estimated increase of $470 million in aggregate payments to SNFs during FY 2014.  The final rule also:

  • Revises and rebases the SNF market basket.
  • Revises and updates the labor related share.
  • Provides instruction on reporting the SNF market basket forecast error.
  • Adds a new item to the Minimum Data Set for reporting the number of distinct therapy days.
  • Adopts a change to the diagnosis code related to the AIDS add-on payment, effective with the ICD-10-CM implementation.

 The FY 2014 SNF payment rate update will be effective on October 1, 2013.

 The final rule is available at:

http://www.gpo.gov/fdsys/pkg/FR-2013-08-06/pdf/2013-18776.pdf.

 The related CMS fact sheet on the final rule is available at:

http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-Sheets/2013-Fact-Sheets-Items/2013-07-31.html.

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2014; Rules, 78 Fed. Reg.  151, 47936, 47936 (Aug. 6, 2013).

Centers for Medicare & Medicaid Services.  “CMS Finalizes Fiscal Year 2014 Payment and Policy Changes for Medicare Skilled Nursing Facilities.”  Fact Sheet.  31 Jul. 2013. 

About the Author

Jennifer Kirchner is a licensed attorney in Illinois and Wisconsin. Ms. Kirchner has expertise in assessing provider compliance with the Anti-Kickback Statute, Stark Law, the False Claims Act, HIPAA Privacy and Security Rules and clinical research laws and regulations.