Fix flaws before changing nursing home pay: AHCA says

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Mark Parkinson, AHCA president and CEO
Mark Parkinson, AHCA president and CEO

The Centers for Medicare & Medicaid Services should consider a higher market basket update for nursing homes due to improper calculations that could be costing providers, the American Health Care Association maintains.

Skilled nursing facility Medicare payments are set to increase 1.4%, or about $500 million, to cover rising costs of goods and services in 2014.

CMS calculations in reaching that figure were flawed in several ways, according to a 24-page report released by AHCA on July 1. 

AHCA said it found several problems with regulators' methods, particularly with how CMS used fiscal 2010 cost reports to determine the market basket rate.

One of the problems is that CMS excluded facilities with zero or negative inpatient routine service costs, AHCA stated in its report. Because this might have excluded many facilities that simply did not fill out an optional worksheet, this could have painted an inaccurate picture, report authors pointed out.

AHCA President and CEO Mark Parkinson said his group's call for rebasing and revising the market basket is “reasonable.” 

“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,” Parkinson said in comments submitted to CMS on its proposed payment rule.

Parkinson also appealed for better payment in comments to Congressional leaders who sent a letter seeking input on post-acute payment reform. 

The AHCA leader said the letter cited a misleading average SNF Medicare margin ofs “22-24 percent.”


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