Senate bill would delay start date of RUG-IV by one year

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A provision in the Senate healthcare reform proposal would delay by one year implementation of version four of the Resource Utilization Group (RUG-IV).

Originally slated to take effect alongside the MDS 3.0 on Oct 1, 2010, RUG-IV would instead start Oct 1, 2011. But implementation of MDS 3.0 would still go forward as planned this Oct. 1, under the Senate bill. Also this Oct. 1, the Department of Health and Human Services would implement the change to concurrent therapy that is a component of RUG-IV. It would also enact on that date changes to the look-back period. Under these look-back changes, only those services furnished after admission to a skilled nursing facility would be factors in determining case-mix classification.

In related news, the Centers for Medicare & Medicaid Services on Monday published the sixth chapter of the Resident Assessment Instrument (RAI) manual. This chapter "explains how the MDS 3.0 is used to support Medicare reimbursement and ensure that claims submitted to Medicare are accurate and meet all Medicare requirements," according to CMS.