Balanced Budget Refinement Act of 1999 (BBRA)

A revision to the BBA that, among other things, provided a temporary increase in payment for certain high-costs patients, increases federal per diem PPS of Medicare patients, and increases the federal rates for all categories of patients. The agreement also permits skilled nursing facilities to choose to receive Medicare payments based 100% on the federal per diem rate rather than partially on a federal per diem rate and partially on a pre-PPS facility-specific rate.