The government is expanding its research into alternative therapy payments, to consider more holistic changes to the way Medicare reimburses skilled nursing facilities, the Centers for Medicare & Medicaid Services announced Tuesday.

The SNF Therapy Payment Research project is exploring ways to improve or replace the current Part A system of reimbursement, which is based on how much therapy is provided rather than on patient characteristics or needs. CMS contracted with research firm Acumen LLC for the project, and the organizations released a report on the first phase of the project in April.

“Although we always intended to ensure that any revisions to therapy payment would consider an integrated approach with the remaining payment methodology, we now plan to examine potential improvements and refinements to the overall SNF PPS payment system,” CMS announced in a website posting.

Stakeholders are invited to submit comments on the SNF Medicare payment methodology by emailing

Therapy billing practices have come under intense scrutiny due to charges of upcoding and other unscrupulous practices. The government recently filed lawsuits against nursing home providers, charging that they did not provide needed oversight of their contracted therapy companies, which allegedly were engaged in fraud.

Long-term care providers should check their PEPPER report to see how their therapy billing stacks up against peer facilities, a legal expert told McKnight’s at the LeadingAge conference in Nashville earlier this week.