Draft legislation proposes SNF readmissions penalties, bundled payments

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Bill proposes SNF readmissions penalties, bundled payments
Bill proposes SNF readmissions penalties, bundled payments

Proposed legislation from the House of Representatives would decrease skilled nursing facilities' Medicare rate updates, introduce new post-acute payment systems and institute readmissions penalties for SNFs.

The House Ways and Means Committee based its draft legislation on proposals from the 2014 White House budget, some of which have also been floated by groups such as the Medicare Payment Advisory Commission. These policies include reducing the annual market basket update for SNFs. This update is meant to keep Medicare reimbursements in line with the rising cost of goods and services.

Other proposals include creating bundled payments for a post-acute episode of care and creating site-neutral payments between inpatient rehabilitation facilities and SNFs, for some procedures.

The discussion draft, released last Friday, includes the establishment of a SNF readmissions program, similar to the one in place for hospitals. This would result in reimbursement penalties for SNFs if they exceed a threshold for readmissions to a hospital for certain conditions, within a particular timeframe. The Centers for Medicare & Medicaid Services recently released data showing about 2,200 hospitals will face readmissions penalties during the next fiscal year, and 18 will see Medicare reimbursements reduced by the maximum of 2%.

The Ways and Means Committee is chaired by Rep. Dave Camp (R-MI). The ranking member is Rep. Sander Levin (D-MI). The committee is accepting comment on the draft legislation through Aug. 30.

In June, leaders of the Ways and Means Committee and the Senate Finance Committee sent a joint letter requesting stakeholder input on how to reform post-acute care. Responses are being accepted through Aug. 19.

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