CMS Issues FY 2024 SNF Proposed Payment Rule

Yesterday, April 4, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2024 update.

Highlights include the following:

• The proposed rule provides for a net market basket increase for SNFs of 3.7% (approximately $1.2 billion) beginning October 1, 2023 — This is the second year the statutory forecast error provision had a profound impact on the net market basket. CMS compares a projected market basket update with the actual market basket update using prior year data. Intended to account for inflation, the forecast increases when the projected market basket is 0.5% less than the actual market basket. Conversely, the forecast decreases when the projected market basket is 0.5% more than the actual market basket. If the variance in either direction is less than 0.5%, no forecast error is incurred. This year, the difference between forecasted and actual, 3.6%, was applied to the unadjusted market basket of 2.7%, resulting in 6.3%. This more than offset the impacts of the second, and final, year of the parity adjustment, a 2.3% reduction, as well as the productivity adjustment, a 0.2% decrease.
• The proposed rule did not include minimum staffing requirements — The CMS fact sheet released with the proposed rule states, “CMS continues to review the feedback and evidence from both the comment solicitation and mixed-methods study, all of which will be used to inform proposals for minimum direct care staffing requirements in nursing homes in rulemaking this spring.”
• Proposed changes to §488.436(a) Civil Money Penalties (CMP) would allow facilities to receive by default the 35% penalty reduction when the facility has not appealed within the 60-day timeframe. If finalized, this would reduce paperwork for facilities, CMS and states as facilities would no longer need to submit a written waiver of a hearing to appeal deficiencies that lead to the imposition of a CMP.

Webinar: AHCA is currently reviewing the proposed rule in detail and will host a member webinar on Friday, April 7 at 2 p.m. ET. More information, including the registration link, will be provided soon at this link. In addition, the webinar will be recorded for those unable to participate in person.