CMS says repeal of RUG-IV delay still possible, to relax MDS transmission rules

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Federal regulators said Thursday they are hoping that Congress will act by the end of the year to keep in place full-time what is now being called a provisional RUG-IV nursing home Medicare payment system. Still, preparations for an alternate system recently began in earnest, an official for the Centers for Medicare & Medicaid Services said Thursday during the agency's monthly SNF Open Door Forum conference call. 

Also today, CMS will formally announce a temporary relaxation of the requirement that MDS data be transmitted within 14 days of a resident's initial assessment, said Chrissy Stillwell-Deaner.

MDS 3.0 “transition issues” are the reason long-term care surveyors will be instructed “to accept the date stamp as evidence of transmission” from Oct. 1 to Dec. 31, she explained.

CMS officials reminded hundreds of listeners on the call that another provider conference call will be held Nov. 9 to answer questions about the new MDS 3.0 resident assessment tool, which went into effect the first day of this month. The start-up has been marred by temporary shutdowns of the system and a variety of coding problems.

Also, a CMS official said the agency is “potentially” going to hold a vendor conference call the middle of the month “to get their issues resolved.”

After next week's elections, the Senate is expected to consider a proposal to repeal a congressional act that delayed full implementation of the RUG-IV system until October 2011. The House has already passed such a bill.

“So there is still a good chance that RUG-IV payments will continue for this entire year and we will not have to go back to a hybrid RUG-III system and then go back to RUG-IV next October,” said Sheila Lambowitz of CMS. “Hopefully, we will know something in the next month.” 

In the meantime, details are being worked out for a possible RUG-III hybrid payment system that could go to providers by the end of the year or “early next year,” she said.

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