The Medicare Payment Advisory Commission has again recommended that skilled nursing facilities receive no inflationary payment adjustment in the coming year. The congressional advisory arm made a similar recommendation last year, which was not heeded.

Congress is not bound to follow MedPAC’s recommendations, and in fact has not done so for several cycles. Providers expected Tuesday’s recommendation, which included another call to reallocate a 6.7% funding add-on for some therapy services to non-therapy services.

“As long as they use the model where they look at the average aggregate margins, they’re going to keep saying, ‘We don’t think they (providers) should get any update.’ But then Congress will go take a closer look and say they should,” said Barbara Manard, vice president for long-term care health strategies for the American Association of Homes and Services for the Aging.

MedPAC also said Tuesday that Health and Human Services Secretary Tommy Thompson should mandate skilled nursing facilities report nursing costs separately.

The commission also voted Tuesday to recommend home-health providers not get a payment update, but that physicians should receive a 2.5% update for fiscal 2005.