Nursing Facility Case-Mix Payment Changes October 1, 2019

CMS issued an informational bulletin earlier this month notifying providers of changes that will impact states’ payments for Medicaid beneficiaries in the nursing home setting.

The bulletin indicates with the implementation of PDPM in October 2019 a new optional assessment, specific for states that rely on RUG-III and RUG-IV assessment schedule, will be available. The assessment will be active from 10/1/2019 through 9/30/2020, at which time states will have to determine an alternate calculation system for Medicaid payment. Additional detail was provided in the December 11th MLN call. Read full bulletin here.

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