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

CMS Finalizes Skilled Nursing Facility FY 2019 PPS Update

The Centers for Medicare and Medicaid Services (CMS) have issued a final rule that will update the Resource Utilization Groups, Version IV (RUG IV) payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year (FY) 2019 (that is, for discharges occurring on or after October 1, 2018, and on or before September 30, 2019).

The rule will replace the existing case-mix classification methodology, the RUG-IV model, with a revised case-mix methodology called the Patient-Driven Payment Model (PDPM) beginning on October 1, 2019 (FY 2020).

The rule also finalizes updates to the SNF Quality Reporting Program (QRP) and the Skilled Nursing Facility Value-Based Purchasing (VBP) Program.

The document is currently on display at the Federal Register office. Publication is scheduled for August 8th. A copy of the 424-page document is at: https://s3.amazonaws.com/publicinspection.federalregister.gov/2018-16570.pdf. This link will be superseded upon publication.

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