The
Centers for Medicare & Medicaid Services set off a backlash from
nursing home operators late Friday afternoon when it proposed
“adjustments” that would cut Medicare payments by $1.05 billion
in fiscal 2010. The 3.3% reduction will “largely” be offset by a
2.1% market basket increase, officials said.
Regulators
stressed they would be simply closing a four-year window in which
providers were paid far more than originally forecasted after a 2006
payment adjustment for certain therapy groupings. Providers, however,
claimed the cut would be working against the spirit of the recently
passed economic stimulus bill, endangering resident care and causing
thousands of caregiver job losses.
"Implementing
this old Bush Administration Medicare regulation will undermine
seniors' future access to quality care in the setting of their
choice” and “sidetrack our sector's ongoing ability to create
good-paying health jobs,” said Bruce Yarwood, president and CEO of
the American Health Care Association (AHCA)..
Although
the announcement might have been a surprise to some, federal
regulators had made no secret of their desire to “correct” the
payment levels. Also, just two days before the CMS proposed rule came
out, the AHCA ally the Alliance for Quality Nursing Home Care
released a study of its own, claiming that, contrary to many reports,
economic conditions were restricting nursing homes' access to
capital, thereby causing widespread negative ripple effects.
Besides
recalibrating and updating skilled nursing facility PPS rates for
fiscal 2010, the rule also would propose a revised case-mix
classification methodology (RUG-IV) and implementation schedule for
fiscal 2011. It would take into account staff-time data derived from
“the recently completed Staff Time and Resource Intensity
Verification (STRIVE) project.” It also would ask for comment on a
possible new requirement for the quarterly reporting of nursing home
staffing data. The agency is accepting public comments on the
proposals until June 30. More can be found
here.