Much to the chagrin of nursing home providers, the advisory arm of the Centers for Medicare & Medicaid Services on Friday issued draft recommendations freezing skilled nursing facility updates for fiscal year 2009.

It could be the third year in a row that the Medicare Payment Advisory Commission suggests a 0% increase to the update, otherwise known as the marketbasket. MedPAC will vote on the draft recommendations early next year.

CMS decided to increase the 2008 fiscal year marketbasket by 3.3%. The 2008 fiscal year began in October.

It is believed that commissioners are against the update, which incorporates cost-of-living increases, because of SNFs’ positive Medicare margins and good access to capital. But the American Health Care Association and the Alliance for Quality Nursing Home Care chided the group for focusing solely on Medicare margins while ignoring Medicaid shortfalls.