Thoughtware

Article 10/03/2018

New SNF Part A Rates for 2019

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On Friday, September 28, 2018, the Centers for Medicare & Medicaid Services (CMS) released certain technical corrections to the skilled nursing facility (SNF) prospective payment system (PPS) final rule for the federal fiscal year (FFY) on the Federal Register public inspection website.

The correction notice appears in the October 3, 2018, Federal Register and is effective as of October 1, 2018. The correction notice made a handful of corrections to terminology and clerical errors in the tables included in the final rule. In addition, the correction notice adopted the corrected wage index included in a related hospital inpatient PPS correction notice. The updated wage index tables included numerous rounding differences from the previous version of the wage index, and three more significant changes:

  • The Twin Falls, Idaho, CBSA, which was added in the final rule, was not included in the updated wage index files accompanying the correction notice. The correction notice made no mention of a change in status of this CBSA.
  • The Port St. Lucie, Florida, CBSA had a 0.0006 decrease in wage index from the amount released in the final rule due to “errors in the wage index data collected from the Medicare cost reports of one hospital.”
  • The rural Colorado area had a 0.0044 increase in wage index due to the mistaken inclusion of a critical access hospital in the wage data.

Wage index values have been updated and are available for download on our website. As a reminder, it’s still not clear from the proposed or final rule or the correction notice how the Quality Reporting Program (QRP) and Value-Based Purchasing (VBP) adjustments are to be shown on provider remittance advices. The rates on our website reflect our current understanding of CMS’ intent, and are based on applying the QRP market basket adjustment, if applicable first, then the VBP 2 percent withholding and finally the VBP incentive payment. As in previous years, Medicare will apply the 2 percent sequestration adjustment last. If remittance advices reflect these rates differently, we will update our online rate file and notify our BKD Thoughtware® subscribers. Keep an eye on The Link for further updates!

Should you have questions, please contact your trusted BKD advisor.