The Centers for Medicare & Medicaid Services’s (CMS) proposed annual update to Medicare Part A reimbursement for skilled nursing facilities, published at 88 Federal Register 21316 (Apr. 10, 2023), includes a number of significant changes to reimbursement, the Quality Reporting System, and the Value-Based Purchasing Program. CMS proposes increasing Part A reimbursement by approximately $1.2 billion (3.7%), which is more than had been expected.
Among other changes of concern to residents’ advocates, CMS proposes to create a “constructive waiver” process, giving facilities an automatic 35% reduction in a civil money penalty even when they fail to waive their right to a hearing in writing, as is now required for the reduction. The same constructive waiver process was proposed by the Trump Administration in 2019, but was never issued as a final rule. CMS also proposes adoption of a resident satisfaction measure for discharged residents: CoreQ, developed by the American Health Care Association. CMS’s Notice of Proposed Rulemaking did not include a proposed nurse staffing ratio for nursing facilities, as anticipated, but CMS intends to publish a proposed rule this Spring.
Comments on CMS-1779-P are due by June 5, 2023.
April 17, 2023 – T. Edelman