Skilled-nursing facility pay to be cut by 11.1%: CMS
The CMS will cut Medicare skilled-nursing facility pay by 11.1%, or $3.87 billion, in fiscal 2012, a move strongly opposed by the SNF industry (July 25, p. 14). The CMS cut the payments to claw back estimated increased reimbursement in the current fiscal year that resulted from unintended changes in SNF Medicare billing for therapy, which had followed changes in how Medicare paid for therapy. The CMS in the rule said it has recalibrated its payment structure, enacted through what it calls resource utilization groups, to correct the incentives that led to billing for higher-cost therapies. They also tightened the rules for SNFs in the timing of allocating group therapy, to also reduce future overbilling. “We believe that any across-the-board cut is unwarranted and problematic, and one of this magnitude is unprecedented,” said a statement from not-for-profit nursing home association LeadingAge. The fiscal 2012 recalibration reduced payments by $4.47 billion, or 12.6%, but that change was partially offset by the update of 1.7%, or $600 million, according to the CMS. The update reflects a 2.7% inflation increase and was reduced by 1% through a productivity adjustment mandated by last year’s Patient Protection and Affordable Care Act. In a separate final rule, the CMS increased payments for inpatient rehabilitation faculties in fiscal 2012 by 2.2%, or $150 million, and also established a new quality reporting system. Wicklund said in the release, describing the decision as “difficult but essential.” The job cuts are part of a broader plan—which also includes physician partnerships and development of core service lines—to cope with the weak economy and the demands of healthcare reform, according to the release. The 376-bed hospital is part of notfor-profit Exempla Healthcare, a two-hospital system based in Denver and sponsored by Sisters of Charity of Leavenworth Health System, Lenexa, Kan. Lutheran Medical Center finished 2009 with $7.8 million in income on $597.8 million in revenue.