CMS should delay changing nursing home Medicare payments due to flawed calculations, AHCA says

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The Centers for Medicare & Medicaid Services should hold off on updating Medicare skilled nursing facility reimbursement rates due to potential problems in its calculation methods, the American Health Care Association stated Monday.

In May, CMS proposed a 1.4% market basket update, which would increase SNF Medicare payments by about $500 million in 2014 to account for rising costs of the goods and services used to deliver care.

The nation's largest provider advocacy group believes it has identified a number of potential issues in how CMS used fiscal year 2010 cost reports in calculating the market basket update, according to AHCA's comment on the proposed rule.

One of these issues is that CMS excluded facilities with zero or negative inpatient routine service costs, AHCA stated in its 24-page report. This may have painted an inaccurate picture, as it potentially excluded a large number of facilities that simply did not fill out an optional worksheet.

AHCA President and CEO Mark Parkinson said rebasing and revising the market basket is “reasonable.”

He added: “We hope to work with CMS to address our data concerns and strongly recommend that the agency defer from rebasing and revising the market basket until it has a full year of more accurate cost reports.”

Click here to access AHCA's full comment on the proposed rule.