CMS’ FY 2020 SNF PPS Final Rule Released

Yesterday, the Centers for Medicare and Medicaid Services (CMS) issued the FY 2020 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule, which will take effect on October 1, 2019. 

This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2020. CMS has also made minor revisions to the regulation text to reflect the revised assessment schedule under the Patient Driven Payment Model (PDPM). Additionally, CMS revised the definition of group therapy under the SNF PPS, and implemented a subregulatory process for updating the code lists ICD-10 used under PDPM. Finally, the final rule updated requirements for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Purchasing (VBP) Program.

Below are a few highlights from the final rule: 

  • The federal rates in this final rule reflect an update to the rates that CMS published in the FY 2019 SNF PPS final rule, which reflects the SNF market basket update, as adjusted by the multifactor productivity (MFP) adjustment, for FY 2020.
  • The SNF market basket percentage is 2.4 percent for FY 2020, which is an increase in payments of $851 million compared to FY 2019. This estimated increase is attributable to a 2.8 percent market basket increase factor with a 0.4 percentage point reduction for the multifactor productivity adjustment. This is a decrease from the proposed update of 2.5 percent and $887 million.
  • Effective October 1, 2019, group therapy will be defined as “a qualified rehabilitation therapist or therapy assistant treating two to six patients at the same time who are performing the same or similar activities.”
  • CMS is not finalizing its proposal to expand data collection for SNF QRP quality measures to all SNF residents, regardless of their payer. 
  • CMS is finalizing as proposed, without modification, the process for updating the ICD-10 code mappings and lists associated with PDPM. As proposed, the subregulatory process for updating the ICD-10 codes used under PDPM will take effect beginning with the updates for FY 2020.   
  • The Final Rule updates requirements for the SNF QRP, including the adoption of two Transfer of Health Information quality measures and standardized patient assessment data elements that SNFs would be required to begin reporting with respect to admissions and discharges that occur on or after October 1, 2020. 
  • CMS is finalizing its proposal to exclude baseline nursing home residents from the Discharge to Community Measure.
  • CMS is finalizing its proposal to publicly display the quality measure, Drug Regimen Review Conducted with Follow-Up for Identified Issues, under the SNF Quality Reporting Program.
  • CMS is replacing the terminology for the “5-Day Assessment” with “Initial Medicare Assessment”.

Password Hygiene

Do you have good password hygiene?  Good password hygiene helps keep your work and personal information safe. 

You have healthy password hygiene if you:

  1. Create strong passwords by establishing passwords minimally 8 characters in length and containing upper case, lower case, and symbols.  A password of more than 8 characters is even better because more guesses will be needed by hackers to get it right.  Even with frequent warnings regarding cyber security, the two most common passwords people use are “password” and “12345678”!
  2. Use a different password for every account or online profile.  Should the system you are using be compromised that password could be published for the world to see.  There are almost 2.7 billion rows of data in the “Have I Been Pwned?” website of account information that has been compromised in data breaches.  This is a respected site that aggregates data breaches in order to make it easy for people to find out if they have been impacted by a breach.  You can check it yourself by going to https://haveibeenpwned.com.  
  3. Use two-factor authentication (2FA) whenever available.  This requires a second code be entered that will be provided through text, email or token in addition to your User ID and Password.
  4. Never write down your User ID or password and particularly never write it down and post it to your computer.

Maintain healthy security by maintaining healthy password hygiene.