Provider groups suggest Medicare payment freezes, gradual recalibrations

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Alan Rosenbloom, president of the Alliance for Quality Nursing Home Care
Alan Rosenbloom, president of the Alliance for Quality Nursing Home Care
The Centers for Medicare & Medicaid Services should keep Medicare payment rates to skilled nursing facilities at the current level for one year, instead of implementing an 11.3% cut in fiscal year 2012, says LeadingAge, a top lobbying organization for providers, in comments submitted to the federal agency.

LeadingAge suggests that CMS should not implement recalibration until it has more information and is able to clear up loopholes that resulted in apparent gross overpayments since last October. LeadingAge also recommended that CMS “clarify the definition of group therapy, restoring the previous distinction between group and concurrent modes, among other proposals.” Providers and CMS have clashed over higher-than-expected payouts for those classified into Rehab Ultra High payment categories.

Comparatively, the American Health Care Association proposed that CMS cut Medicare reimbursement rates by 3% and not partake in a market basket update. AHCA recommends that in fiscal 2013 and subsequent years, CMS could further reduce rates by up to 3%, and add in any market basket update, until budget neutrality is reached.

Similar to AHCA, the Alliance for Quality Nursing Home Care's President Alan G. Rosenbloom on Thursday suggested that CMS implement a 3% payment reduction beginning in fiscal 2012. The Alliance proposes CMS then continue to evaluate and adjust payment rates every six months, based on additional data and experience with the new system.

LeadingAge also said it would like CMS to adopt the reporting requirements for IRS Form 990, known as the Return of Organization Exempt From Income Tax, as compliant with the requirements for disclosure of additional parties. The filing is needed to maintain tax-exempt status, which is critical for not-for-profit providers. Comments on the Form 990 are due August 1. 


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